RESUMEN
OBJECTIVE: The objective of this study was to investigate the effects of acupuncture treatment for persistent hiccups in cancer patients. DESIGN: The study design was a retrospective case series. SETTINGS/LOCATION: The study setting was the Clinical Research Center of the National Institutes of Health. SUBJECTS: The subjects were 16 adult male patients ages 27-71 with cancer, with persistent hiccups. INTERVENTIONS: There were one to three acupuncture sessions over a 1-7-day period. OUTCOME MEASURES: Treatment efficacy was measured using a hiccup assessment instrument pre- and post-treatment. The effects of acupuncture on common symptoms reported by all patients were also evaluated. RESULTS: Thirteen (13) patients experienced complete remission of persistent hiccups (p < 0.0001); 3 patients experienced decreased hiccups severity. Significant improvement was observed in discomfort (p < 0.0001), distress (p < 0.0001), and fatigue (p = 0.0078). CONCLUSIONS: This case series demonstrates that acupuncture may be a clinically useful, safe, and low-cost therapy for persistent hiccups in patients with cancer.
Asunto(s)
Terapia por Acupuntura , Hipo/terapia , Neoplasias/complicaciones , Adulto , Anciano , Fatiga/etiología , Fatiga/terapia , Hipo/clasificación , Hipo/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Dolor/etiología , Manejo del Dolor , Inducción de Remisión , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Estrés Psicológico/etiología , Estrés Psicológico/terapia , Resultado del TratamientoAsunto(s)
Humanos , Masculino , Persona de Mediana Edad , Diafragma/anatomía & histología , Electrocardiografía Ambulatoria/métodos , Hipo/clasificación , Hipo/patología , Hipo/terapia , Nervio Frénico/lesiones , Nervio Vago/anatomía & histología , Palpación/efectos adversos , Estómago/lesiones , Glotis/fisiología , Anamnesis , Reflujo Gastroesofágico/etiologíaRESUMEN
There are close to a hundred causes for hiccups, or singultus, the most common of which are gastrointestinal. Causes may be natural or drug induced, and the same agents that are used to treat hiccups may also induce them. Hiccups can be classified by their duration, as follows: up to 48 hours, acute; longer than 48 hours, persistent; and more than two months, intractable. Treatment options for hiccups can include both pharmacologic and nonpharmacologic agents. If the cause of hiccups can be identified, it is, of course, preferable to direct the treatment at that cause. However many times a cause cannot be identified; in this case, general measures or treatments should be instituted. Intractable hiccups can occur in the palliative care population. When they do, it can be extremely distressing and have a significant impact on quality of life. Pharmacologic approaches are often the most rational therapies for these patients. Baclofen seems to be a promising drug for use with both palliative care and perioperative patients, and using garabentin as an add-on to baclofen may also be a reasonable option to consider