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Related Concept Videos

Drugs Acting on Autonomic Ganglia: Blockers01:28

Drugs Acting on Autonomic Ganglia: Blockers

Ganglionic blockers inhibit autonomic activity by blocking nicotinic receptors in the autonomic ganglia, suppressing impulse transmission. These blockers lack selectivity between sympathetic and parasympathetic ganglia and are ineffective as neuromuscular junction antagonists. They can be categorized into two groups:
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Depolarizing Blockers: Mechanism of Action01:28

Depolarizing Blockers: Mechanism of Action

Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because succinylcholine...
Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...

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Related Experiment Video

Updated: Jun 11, 2026

Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
09:35

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Intractable Hiccups Treated With Stellate Ganglion Block: Case Report.

Danielle Levin1, Jonathan Alabre1, Ryan Gualtier1

  • 1Anesthesiology, Critical Care & Pain Medicine, New York University, New York, NY.

Pain Medicine Case Reports
|June 30, 2025
PubMed
Summary
This summary is machine-generated.

Idiopathic intractable hiccups can be debilitating. An ultrasound-guided stellate ganglion (SG) block provided temporary relief for a patient resistant to other treatments, offering a new therapeutic avenue.

Keywords:
Stellate ganglion blockintractable hiccupslocal anestheticultrasound

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Area of Science:

  • Neurology
  • Pain Management

Background:

  • Hiccups are involuntary diaphragm contractions; acute cases are common, but prolonged or intractable cases are rare and impact quality of life.
  • Idiopathic intractable hiccups, lasting over a month, present a significant clinical challenge.
  • Conventional treatments, including oral medications and phrenic nerve blocks, may be ineffective for persistent hiccups.

Observation:

  • A 73-year-old male patient experienced over three years of idiopathic intractable hiccups.
  • The patient's condition was refractory to standard oral pharmacotherapy and phrenic nerve blocks.
  • An ultrasound-guided stellate ganglion (SG) block was performed using ropivacaine and lidocaine.

Findings:

  • Following the SG block, the patient achieved complete, 100% hiccup-free status for one week.
  • This marked the first significant relief experienced by the patient in over three years.
  • The procedure demonstrated a positive short-term outcome for intractable hiccups.

Implications:

  • Ultrasound-guided SG block may serve as a viable temporary treatment for idiopathic intractable hiccups.
  • This minimally invasive procedure offers a potential alternative for refractory hiccup cases.
  • Further research is warranted to explore the efficacy and duration of SG blocks for intractable hiccups.