Cricoid pressure and its effect on tracheal intubation by direct laryngoscopy

Authors:SHEKHAR GANESH ANEY, AJU JOY, RAWAT H.S
Int J Biol Med Res. 2018; 9(4): 6481-6484  |  PDF File

Abstract

Background and Aim: Cricoid pressure is a vital skill that should be performed during emergency tracheal intubation. The efficacy of cricoid pressure to prevent pulmonary aspiration of gastric content has never been demonstrated and several observations have suggested that cricoid pressure can make intubation more difficult, its effects on tracheal intubation should be studied Material and Methods: A total number of 100 patients who were scheduled for elective hand and forearm surgeries were studied. Patients were randomly assigned to receive either cricoid pressure (CP) or sham cricoid pressure (SCP). Patients were manually ventilated with 100% oxygen by mask until complete paralysis achieved. In the cricoid pressure group a standardize CP was applied whereas in, sham cricoid pressure group the cricoid cartilage was identified and the finger was positioned as in cricoid pressure group but no pressure was applied. The anaesthesiologist rated the grade of laryngoscopy view on the Cormack and Lehane scale and was asked whether the larynx was in midline position or shifted laterally. Results and Conclusion: It may be concluded that CP, when applied properly, may not worse the visualization of cords. However, need to intubate or ventilate can mandate partial release of cricoid pressure when airway difficulties arises. Hence application of CP should not be avoided for fear of increasing difficulty in intubation by direct laryngoscopy, when its use is actually indicated.