Nurten İNAN, Avni BABACAN, Didem AKÇALI, Oktay TERTEMİZ

Dirençli Hıçkırık Tedavisinde Frenik Sinire Pulse Radyofrekans Uygulaması

Hıçkırığın yüzden fazla nedeni vardır. Hıçkırık günler, haftalar, hatta aylarca devam edebilir. Dirençli veya persistan hıçkırık; depresyon, yorgunluk, bozulmuş uyku düzeni, dehidratasyon, malnütrisyon ve aspirasyona yol açabilir. Hıçkırık non-invaziv veya farmakolojik ajanlarla tedavi edilebilir. Eğer bu yöntemler başarısız olursa frenik sinir blokajı veya cerrahi tedaviler uygulanabilir. Biz, bu yazıda persistan ve dirençli hıçkırığı olan, konservatif tedaviye yanıt vermeyen fakat sinir stimülatörü eşliğinde uygulanan frenik sinir blokajı ile geçici etki elde edilen ve takibinde frenik sinire uygulanan pulse radyo frekans (pulse RF) sonrasında hıçkırığı geçen56 ve 52 yaşlarında iki olguyu sunduk.

Pulsed Radiofrequency Lesioning of the Phrenic Nerve in Treatment of Intractable Hiccup

There are more than hundred reasons of hiccups and they can last as long as days, weeks or even months. Persistent hiccups can cause depression, fatigue, altered sleeping pattern, dehydration, malnutrition and aspiration. Hiccups can be treated using non-invasive or pharmacological agents. Should these methods fail; phrenic nerve block or surgical procedures can be used. In this paper, we have presented two cases that involve patients of age 56 and 52, with persistent and intractable hiccups irresponsive to conservative treatment, whose hiccups was treated by phrenic nerve block using nerve simulator temporarily, followed-up by pulsed radiofrequency applied on phrenic nerve.

PDF

___

Ong AM, Tan CS, Foo MW, Kee TY. Gabapentin for intractable hiccups in a patient undergoing peritoneal dialysis. Perit Dial Int 2008;28: 667- 8.
Schreiber LR, Bowen MR, Mino FA, Craig TJ. Hiccups due to gastroesophageal reflux. South Med J 1995;88: 217-9.
Kuusniemi K,Pyylampi V. Phrenic nerve block with ultrasound- guidance for treatment of hiccups: a case report. J Med Case Rep 2011;5:493.
Renes SH, Van Geffen GJ, Rettig HC, Gienlen MJ, Scherffer GJ. Ultrasound-guided continuous phrenic nerve block for persistent hiccups. Reg Anesth Pain Med 2010;35:455-7.
Michalek P, Kautznerova D. Combined use of ultrasonography and neurostimulation for therapeutic phrenic nerve block Reg Anesth Pain Med. 2002;27:306-308.
Kang KN, Park IK, Suh JH, Leem JG, Shin JW. Ultrasound-guided pulsed radiofrequency lesioning of the phrenic nerve in a patient with intractable hiccup. Korean J Pain 2010;23: 198-201.
Racz GB, Ruiz-Lopez R. Radiofrequency procedures. Pain Practice. 2006; 6:46-50
Cosman ER Jr, Cosman ER Sr. Electric and thermal field effects in tissue around radiofrequency electrodes. Pain Med 2005;6: 405-24.
Cahana A, Vutskits L, Muller D. Acute differential modulation of synaptic transmission and cell survival during exposure to pulsed and continuous radiofrequency energy. J Pain 2003; 4: 197-202.
Calvo E, Ferna´ndez-La Torre F, Burgarolas A: Cervical phrenic nerve blockfor intractable hiccups in cancer patients: J Natl Cancer Inst. 2002; 94: 1175-6. İnan ve ark.