J Korean Pain Soc.  1997 Nov;10(2):246-249.

Treatment of Intractable Hiccup with Midazolam and Baclofen

• Yang NY
• Moon DE
• Park CJ
• Kwon OK
• Park CM
• Shim JY
• Choi JH

Abstract

Hiccup is defined as an abrupt involuntary contraction of the diaphragm and intercostal muscles with sudden closure of the glottis 35 msec after onset. The term ""intractable"" is given to those hiccups with a duration ranging from 24 hours to more than 25 years. Short hiccup bouts are mostly associated with gastric distention or alcohol intake, resolved spontaneously or with simple remedies. In contrast, intractable hiccup is a rare but disabling condition which can induce depression, weight loss and sleep deprivation. Although the pathophysiologic mechanisms of hiccup are still poorly understood, wide variety of pathological conditions such as: brain tumor, abdominal tumor, myocardial infarction, renal failure, abdominal surgery etc., can cause intractable hiccup. A 58-year-old male who had suffered from hepatocellular cancer was consulted from medical department due to intractable hiccup. Initial treatment modalities with administrations of metoclopramide and chlorpromazine and nerve blocks including phrenic nerve block, cervical epidural block and glossopharyngeal nerve block were not effective. Administration of midazolam and baclofen however achieved desirable effect.

Keyword

Pharmacology, midazolam, baclofen; Reflex, hiccup

MeSH Terms

Baclofen*
Brain Neoplasms
Chlorpromazine
Depression
Diaphragm
Glossopharyngeal Nerve
Glottis
Hiccup*
Humans
Intercostal Muscles
Liver Neoplasms
Male
Metoclopramide
Midazolam*
Middle Aged
Myocardial Infarction
Nerve Block
Phrenic Nerve
Renal Insufficiency
Sleep Deprivation
Weight Loss
Baclofen
Chlorpromazine
Metoclopramide
Midazolam