Korean J Pain.  2010 Sep;23(3):198-201. 10.3344/kjp.2010.23.3.198.

Ultrasound-guided Pulsed Radiofrequency Lesioning of the Phrenic Nerve in a Patient with Intractable Hiccup

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sjinwoo@hotmail.com

Abstract

Persistent and intractable hiccups (with respective durations of more than 48 hours and 1 month) can result in depression, fatigue, impaired sleep, dehydration, weight loss, malnutrition, and aspiration syndromes. The conventional treatments for hiccups are either non-pharmacological, pharmacological or a nerve block treatment. Pulsed radiofrequency lesioning (PRFL) has been proposed for the modulation of the excited nervous system pathway of pain as a safe and nondestructive treatment method. As placement of the electrode in close proximity to the targeted nerve is very important for the success of PRFL, ultrasound appears to be well suited for this technique. A 74-year-old man suffering from intractable hiccups that had developed after a coronary artery bypass graft and had continued for 7 years was referred to our pain clinic. He had not been treated with conventional methods or medications. We performed PRFL of the phrenic nerve guided by ultrasound and the hiccups disappeared.

Keyword

hiccup; pulsed radiofrequency; ultrasound

MeSH Terms

Aged
Coronary Artery Bypass
Dehydration
Depression
Electrodes
Fatigue
Hiccup
Humans
Malnutrition
Nerve Block
Nervous System
Pain Clinics
Phrenic Nerve
Stress, Psychological
Transplants
Weight Loss

Figure

  • Fig. 1 Ultrasound image of needle tip which is adjacent to phrenic nerve for nerve block.

  • Fig. 2 Ultrasound image of patient's phrenic nerve and related structures for pulsed radiofrequency lesioning.


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