Complications
Severe hiccups can interfere with ventilation in anesthetized and ventilated patients. This is often seen with the use of a laryngeal mask airway. Hiccups in intubated infants can lead to hyperventilation and subsequent respiratory alkalosis.[44]
Severe forms of hiccups during surgery, endoscopy, or imaging can jeopardize the quality of the procedure.
In the rare situation where hiccups cause a sudden interference with a medical procedure or imaging study (endoscopy, surgery, computed tomographic scan, magnetic resonance imaging), the patient can be anesthetized with either a volatile or nonvolatile anesthetic to achieve deeper sedation. If this is unsuccessful, neuromuscular blocking agents (e.g., vecuronium) and mechanical ventilation can be used to arrest the symptom. After the effects of the neuromuscular blocker wear off, the hiccups often return, and it should be noted that anesthesia and securing the airway (e.g., with a laryngeal mask airway) may not be beneficial and may even cause a worsening of symptoms.[44][45]
Hiccups in the postoperative period do not only cause discomfort but can also lead to wound dehiscence and insufficiency at the site of an anastomosis.
Severe forms of chronic hiccups can complicate eating and drinking. This may lead to malnutrition and dehydration, with subsequent weight loss.
Hiccups can result in reflux, leading to esophagitis. Persistent reflux worsens the symptoms of esophagitis, which is itself a cause of chronic hiccups. Thus, a vicious cycle is created that must be interrupted.
Supraventricular and ventricular arrhythmias can result from severe diaphragmatic contractions. It should be noted that some underlying conditions can lead to both cardiac arrhythmias and hiccups.
Hiccups may keep the individual from sleeping, leading to fatigue and exhaustion during the day. Alertness and concentration are impaired, with consequences for work and social activities. Constant stimulation of the sympatho-adrenergic system may lead to adverse effects on the cardiovascular system.
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