Successful Management of Intractable Hiccups in Diabetic Ketoacidosis: A Case Report on the Efficacy of Inhaled Nebulized Lidocaine

Intractable hiccups are a rare but distressing symptom that can significantly impair a patient's quality of life, particularly in those with underlying medical conditions such as diabetic ketoacidosis (DKA). This case report describes a 59-year-old male patient with a history of type 2 diabetes mellitus and hypertension who presented to the emergency department with persistent hiccups lasting for five days, coinciding with an exacerbation of his diabetes leading to DKA. Despite initial treatments with metoclopramide, chlorpromazine, and baclofen, the hiccups persisted, causing considerable distress. The patient was subsequently treated with inhaled nebulized lidocaine at a dosage of 150 mg daily for two days. Remarkably, within 24 hours, the patient experienced a significant reduction in hiccup frequency, and by the end of the treatment course, the hiccups had completely resolved. This case highlights the potential efficacy of nebulized lidocaine as an alternative treatment for intractable hiccups associated with DKA, particularly when conventional therapies fail. Given the promising results, further research is warranted to explore the mechanisms and broader applicability of this treatment approach in similar patient populations.