Dexamethasone-induced Singultus Post-dental Extraction: A Case Report

Abstract

Hiccups are involuntary reflexes, usually habitual and self-limiting in nature, experienced by the majority of people at some point in their lives. Persistent hiccups induced by pharmacotherapeutic agents, such as steroids, are considered minor complications. They can cause extreme discomfort and significantly lower the patient’s quality of life. This is the first report of persistent severe hiccups after Dexamethasone intramuscular administration in Indian patients post-dental treatment. Hereby, the authors present a case of a 50-year-old male patient with a medical history of Rheumatoid arthritis who was administered 8 mg of dexamethasone Intramuscular (IM) post-extraction. The patient was extremely restless when he reported to the dental clinic, as he had developed persistent hiccups post-24 hours. Neither the home remedies by the patient nor the topical application gel prescribed by the clinician were successful. As intractable hiccups continued for upto 34 hours, immediate action was taken, and the patient was referred to the physician. Pharmacological agents were administered, and the patient’s hiccups resolved completely by 42 hours. At the 1-week postoperative appointment, counseling was given on the suspected drug-induced cause of the transient hiccups for his future benefit. There is limited literature in dentistry on the management of drug-induced hiccups, despite the fact that clinicians routinely prescribe steroids postoperatively. The present case report comprehensively discusses the treatment algorithm for managing patients with drug-induced hiccups. Further studies are necessary to investigate the role of potential biomarkers for indicating the susceptibility of patients likely to develop severe persistent hiccups post-administration of steroids.

Keywords

• adverse reactions
• corticosteroid
• drug related side-effects
• hiccups