Abstract
Summary
Hiccups (singultus) are paroxysmal involuntary contractions of the diaphragm and external intercostal muscles that are terminated by abrupt closure of the glottis, and result in the production of a characteristic sound. Aside from physical and psychological distress, prolonged hiccups produce sleep and alimentary disorders. During ophthalmic surgery, hiccup‐induced head movements are troublesome for the surgeon, and expose the patient to risk of unexpected eye injury and poor surgical outcome. We describe anaesthesia in a patient with intractable, therapy‐resistant hiccup of protracted duration (18 yr) scheduled for cataract extraction. In this case, general anaesthesia (without neuromuscular blocking agents) successfully inhibited the hiccup reflex arc and induced a sustained relief of symptoms. It is a reminder that not all hiccups derive from diaphragmatic stimulation, and that general anaesthesia may offer relief in hiccup mediated via central mechanisms.