Hiccups after Surgery (GA)

Hiccups may occur after surgery with general anesthesia, seen more after propofol induction. This usually appear after the effect of anesthesia wears off.

Hiccups occur when a spasm contracts the diaphragm. This spasm causes an intake of breath that is suddenly stopped by the closure of the vocal cords (glottis). This closure causes the characteristic “hiccup” sound.

Hiccups are a common experience, and warrant treatment only when they become persistent and bothersome. Hiccups usually stop within a few minutes to a few hours. Hiccups that last longer than 48 hours are called persistent hiccups. Hiccups that last longer than a month are called intractable hiccups. Both persistent and intractable hiccups may be a sign of a more serious health problem.

There are many potential causes of hiccups, most of which are gastrointestinal and involve vagal and phrenic nerve stimulation. Other causes include central nervous system disorders, metabolic disorders, psychogenic disorders, and drugs. Metabolic causes of hiccups include hypokalemia, hypocalcemia, hypocarbia (hyperventilation), and uremia.

Self-help

However, there are steps you can try which may help to stop your hiccups. These include:

and Holding your breath and counting slowly to 10.

and Breathing repeatedly into a paper bag for a limited period of time.

and Quickly drinking a glass of cold water.

Medications

Baclofen (Liofen)-Baclofen a muscle relaxant in dosages of 10-20 mg 3 times daily has been shown to be effective in alleviating hiccups. Baclofen is a GABA analogue which leads to a perceptual blockage in synaptic transmission, and is now considered the drug of choice for the treatment of hiccups.

Chlorpromazine (Largactil/Emetil)

Chlorpromazine is a dimethylamine derivative of phenothiazine. It acts centrally by dopamine antagonism in the hypothalamus. A usual dosage would be 10- 25 mg 2-3 times a day is enough.