Nonpharmacologic Management of Acute Singultus (Hiccups)
Unfortunately, this approach is not as well known today, and even recent reviews on the management of intraoperative hiccups fail to mention it.5 Hiccups were very common when anesthesia was induced with barbiturates. Although hiccups can occur in association with propofol, many anesthesiologists are no longer familiar with the nasal trumpet intervention.6 We surveyed faculty and residents at our institution, and only 2 of 21 anesthesiologists were aware of this simple method.
We recently had 2 patients who developed hiccups after propofol for placement of a laryngeal mask. Increasing the depth of anesthesia with additional propofol and volatile agents did not stop the hiccups. In both cases, insertion of a large lubricated nasal trumpet stopped the hiccups within seconds.
We wish to bring this method to your readers’ attention because nasal-pharyngeal stimulation is an effective way to stop acute hiccups while avoiding polypharmacy.