Intractable repetitive
hiccups are a rare prolongation of the common physiologic reflex
arc. If left untreated, chronic
hiccups can decrease a patient's quality of life. Many nonpharmacologic, pharmacologic, and interventional treatment modalities have emerged. A 53-year-old male with a past medical history of a motor vehicle collision (MVC) two years earlier presented to a pain clinic with
hiccups lasting several months. The patient was experiencing
weight loss, lack of sleep, mood changes, and
aspiration pneumonia requiring hospitalization secondary to the
hiccups. Vagal and respiratory maneuvers and multiple
prescription drugs failed to offer
hiccup cessation. An ultrasound-guided stellate ganglion block offered immediate, prolonged cessation of the
hiccups. When nonpharmacologic and pharmacologic
therapies fail to offer improvement of
hiccups, as in our patient's case, a stellate ganglion (SG) block may be a viable treatment option for medically refractory cases.