Evidence map›Paper›PMID 39217317›Full record

ArticleBMC anesthesiology2024

The annoyance of singultus: a case report of a rare adverse effect after epidural steroid injection.

Shayla Mena, Ashneel Raj, William Caldwell, Amit Kaushal

Abstract readCase Reports
In one paragraph

Article in BMC anesthesiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Shayla MenaDepartment of Anesthesiology and Pain Management, Cleveland Clinic, 9500 Euclid Avenue, C25, Cleveland, OH, 44195, USA. MENAS3@ccf.org.
Ashneel RajDepartment of Anesthesiology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Road, Health Sciences Center, Level 4, Stony Brook, NY, 11794, USA.
William CaldwellDepartment of Anesthesiology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Road, Health Sciences Center, Level 4, Stony Brook, NY, 11794, USA.
Amit KaushalDepartment of Anesthesiology, Stony Brook University Renaissance School of Medicine, 101 Nicolls Road, Health Sciences Center, Level 4, Stony Brook, NY, 11794, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveCervical epidural steroid injections (ESIs) can provide effective pain management for patients suffering from chronic neck pain due to various pathological changes of the cervical spine. There are several rare adverse effects reported from interventional pain procedures, including persistent hiccups ("singultus"). Based on a limited number of cases, we propose a modified treatment algorithm for this adverse outcome (Fig. 3). CASE REPORT: Singultus has been documented as an adverse effect of interventional pain procedures, including epidural steroid, facet joint, and sacroiliac joint injections. We describe the case of a general contractor who presented to our clinic with chronic neck pain and central canal stenosis. The patient received an uncomplicated lumbar ESI in the past and was recommended for a cervical interlaminar ESI. After an uneventful C6-C7 interlaminar ESI with dexamethasone, 1% lidocaine, and normal saline the patient developed singultus. Baclofen was sent to his pharmacy, but this was unsuccessful at alleviating his hiccups. The patient was subsequently started on chlorpromazine and found relief from his symptomatology.

conclusionPersistent hiccups after ESI or interventional pain procedures can be treated with conservative measures and non-pharmacologic methods, with escalation to therapy with baclofen, gabapentin, pregabalin, metoclopramide, chlorpromazine, other antipsychotic or antidopaminergic agents, and possible dual or triple therapy if further indicated.

Indexed as

HiccupNeck PainChronic PainDexamethasoneHumansInjections, EpiduralMaleDexamethasoneAdverse effectHiccupsInterventional pain proceduresPain managementSingultus

Identifiers

PMID39217317
PMCPMC11365228

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.