The treatment of persistent hiccough is at times extremely difficult. Several methods, including direct pressure, carbon dioxide inhalations, sedatives, and electro-phrenic stimulation, have been used with varying degrees of success. There are those cases, however, in which the usual methods fail.
In the past four years phrenic-nerve traction has been used successfully where other methods have failed. One patient required bilateral phrenic traction.
Fluoroscopy is used to determine which portion of the diaphragm is involved. Phrenic-nerve traction is accomplished by exposing the nerve in the neck (with use of local procaine hydrochloride [Novocain] anesthesia) through a 4 cm. incision located 3 cm. above and parallel to the clavicle, beginning just lateral to the midline anteriorly.
The incision is carried down through the skin, superficial fascia, and platysma, exposing the sternocleidomastoid muscle. The sternocleidomastoid is retracted anteriorly, exposing the scalenus anticus muscle upon which is found the phrenic nerve passing obliquely
SLEMMER RE. Phrenic N erve Traction for P ersistent Hiccough (Singultus)A Preliminary Report. AMA Arch Surg. 1955;71(6):927–928. doi:10.1001/archsurg.1955.01270180133019
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