Stellate Ganglion Block for Intractable Hiccups Secondary to a Motor Vehicle Collision

Intractable repetitive hiccups are a rare prolongation of the common physiologic reflex arc. If left untreated, chronic hiccups can decrease a patient's quality of life. Many nonpharmacologic, pharmacologic, and interventional treatment modalities have emerged. A 53-year-old male with a past medical history of a motor vehicle collision (MVC) two years earlier presented to a pain clinic with hiccups lasting several months. The patient was experiencing weight loss, lack of sleep, mood changes, and aspiration pneumonia requiring hospitalization secondary to the hiccups. Vagal and respiratory maneuvers and multiple prescription drugs failed to offer hiccup cessation. An ultrasound-guided stellate ganglion block offered immediate, prolonged cessation of the hiccups. When nonpharmacologic and pharmacologic therapies fail to offer improvement of hiccups, as in our patient's case, a stellate ganglion (SG) block may be a viable treatment option for medically refractory cases.