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Treatment of hiccup during general anaesthesia or sedation: a qualitative systematic review

Published online by Cambridge University Press:  02 June 2005

P. Kranke ,
L. H. Eberhart ,
A. M. Morin ,
J. Cracknell ,
C.-A. Greim  and
N. Roewer
P. Kranke
Affiliation:
Department of Anaesthesiology, University of Würzburg, Germany
L. H. Eberhart
Affiliation:
Department of Anaesthesiology, University of Marburg, Germany
A. M. Morin
Affiliation:
Department of Anaesthesiology, University of Marburg, Germany
J. Cracknell
Affiliation:
Bispebjerg University Hospital, Bispebjerg, Denmark
C.-A. Greim
Affiliation:
Department of Anaesthesiology, University of Würzburg, Germany
N. Roewer
Affiliation:
Department of Anaesthesiology, University of Würzburg, Germany
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Extract

Summary

Background and objective: Acute hiccup is a minor complication that can occur during sedation or general anaesthesia. The disorder can disturb the surgical field, might interfere with lung ventilation or could hamper diagnostic procedures. The objective was to perform a systematic search for interventions aimed at treating hiccup occurring during anaesthesia or sedation.

Methods: A systematic search for reports describing interventions to treat hiccup in conjunction with anaesthesia was carried out (MEDLINE, EMBASE, Cochrane-Library, manual screening of reference lists and review articles, up to December 2001). Search terms were ‘hiccup’, ‘singultus’ or ‘hiccough’.

Results: Twenty-six reports involving approximately 581 patients focused on hiccup remedies in the anaesthesia setting. Only one report was substantiated by a randomized controlled trial. This investigated methylphenidate 10 mg intravenously in 51 patients, which did not show a beneficial effect compared with placebo. Hiccup was a self-limiting phenomenon. Case series and case reports focused on various systemically applied drugs in 12 reports, stimulating techniques (e.g. pharyngeal stimulation) in seven, topical applied remedies (e.g. intranasal ice-cold water) in four, and ventilation techniques (e.g. continuous positive pressure ventilation) in two.

Conclusions: A large variety of interventions have been proposed for the treatment of hiccup during anaesthesia and sedation. However, perioperative treatment is still based on empirical findings and no treatment is ‘evidence-based’. Thus, no valid recommendations for the treatment of hiccup can be derived. Uncontrolled observations are inadequate to establish treatment efficacy.

Keywords

RESEARCH DESIGN, meta-analysisSIGNS AND SYMPTOMS, DIGESTIVE, hiccup
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 3 , March 2003 , pp. 239 - 244
Copyright
© 2003 European Society of Anaesthesiology

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