DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20205738

Cricoid pressure controversies

Harpreet Kaur, Ravi Pareek, Harsh Kumar Harsh, Veena Shukla, Nitin Tulsyan

Abstract


Rapid sequence induction (RSI) is a common technique used in clinical anaesthesia to prevent pulmonary aspiration of gastric contents. Sellick introduced this in 1961. However, scientific validation to show the advantage of this technique in preventing aspiration is limited in literature. Numerous researches have shown that cricoid pressure (CP) application might have no benefit in preventing aspiration. Additionally this could lead to problems in securing the airway. Proper teaching and regular training sessions of this technique are mandatory in routine anaesthesia practice.


Keywords


Aspiration, Airway, Cricoid pressure, Rapid sequence induction

Full Text:

PDF

References


Walls RM, Brown CA, Bair AE, Pallin DJ. Emergency airway management: a multi-centre report of 8937 emergency department intubations. J Emerg Med. 2011;41:347-54.

Sagarin MJ, Barton ED, Chng YM, Walls RM, National Emergency Airway Registry Investigators. Airway management by US and Canadian emergency medicine residents: a multicenter analysis of more than 6,000 endotracheal intubation attempts. Ann Emerg Med. 2005;46:328-36.

Sagarin MJ, Chiang V, Sakles JC, Barton ED, Wolfe RE, Vissers RJ, et al. Rapid sequence intubation for pediatric emergency airway management. Pediatr Emerg Care. 2002;18:417-23.

Schwartz DE, Matthay MA, Cohen NH. Death and other complications of emergency airway management in critically ill adults. A prospective investigation of 297 tracheal intubations. Anesthesiology. 1995;82:367-76.

Stewart JC, Bhananker S, Ramaiah R. Rapid-sequence intubation and cricoid pressure. Int J Crit Illn Inj Sci. 2014;4(1):42-9.

Salem MR, Sellick BA, Elam JO. The historical background of cricoid pressure in anesthesia and resuscitation. Anesth Analg. 1974;53:230-2.

Sellick BA. Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia. Lancet. 1961;2:404-6.

Butler J, Sen A. Best evidence topic report. Cricoid pressure in emergency rapid sequence induction. Emerg Med J. 2005;22:815-6.

Fenton PM, Reynolds F. Life-saving or ineffective? An observational study of the use of cricoid pressure and maternal outcome in an African setting. Int J Obstet Anesth. 2009;18:106-10.

Lerman J. On cricoid pressure: “May the force be with you”. Anesth Analg. 2009;109:1363-6.

Murray MJ, Coursin DB, Pearl RG, Prough DS, editors. Critical Care Medicine: Perioperative Management. Philadelphia: Lippincott-Raven Publishers; 1997. Management of the airway and endotracheal intubation.

Landsman I. Cricoid pressure: Indications and complications. Paediatr Anaesth. 2004;14:43-7.

Schmalfuss IM, Mancuso AA, Tart RP. Postcricoid region and cervical esophagus: normal appearance at CT and MR imaging. Radiology. 2000;214:237-46.

Rice MJ, Mancuso AA, Gibbs C, Morey TE, Gravenstein N, Deitte LA. Cricoid pressure results in compression of the postcricoid hypopharynx: The esophageal position is irrelevant. Anesth Analg. 2009;109 :1546-52.

Tsung JW, Fenster D, Kessler DO, Novik J. Dynamic anatomic relationship of the esophagus and trachea on sonography: implications for endotracheal tube confirmation in children. J Ultrasound Med. 2012;31:1365-70.

Smith KJ, Dobranowski J, Yip G, Dauphin A, Choi PT. Cricoid pressure displaces the esophagus: an observational study using magnetic resonance imaging. Anesthesiology. 2003;99:60-4.

Bhatia N, Bhagat H, Sen I. Cricoid pressure: where do we stand? J Anaesthesiol Clin Pharmacol. 2014;30:3-6.

Vanner RG, Pryle BJ. Nasogastric tubes and cricoid pressure. Anaesthesia. 1993;48:1112-3.

Zeidan AM, Salem MR, Mazoit JX, Abdullah MA, Ghattas T, Crystal GJ. The effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study. Anesth Analg. 2014;118:580-6.

Fanning GL. The efficacy of cricoid pressure in preventing regurgitation of gastric contents. Anesthesiology. 1970; 32:553-5.

Salem MR, Joseph NJ, Heyman HJ, Belani B, Paulissian R, Ferrara TP. Cricoid compression is effective in obliterating the esophageal lumen in the presence of a nasogastric-tube. Anesthesiology. 1985;63:443-6.

Cook TM, Godfrey I, Rockett M, Vanner RG. Cricoid pressure: Which hand? Anaesthesia. 2000;55:648-53.

Vanner RG, Asai T. Safe use of cricoid pressure. Anaesthesia. 1999;54:1-3.

Nafiu OO, Bradin S, Tremper KK. Knowledge, attitude, and practice regarding cricoid pressure of ED personnel at a large US teaching hospital. J Emerg Nurs. 2009;35:11-5.

Ovassapian A, Salem MR. Sellick’s maneuver: To do or not do. Anesth Analg. 2009;109:1360-2.

Ellis DY, Harris T, Zideman D. Cricoid pressure in emergency department rapid sequence tracheal intubations: a risk-benefit analysis. Ann Emerg Med. 2007;50:653-65.

Ufberg JW, Bushra JS, Karras DJ, Satz WA, Kueppers F. Aspiration of gastric contents: Association with prehospital intubation. Am J Emerg Med. 2005;23:379-82.

Ng A, Smith G. Gastroesophageal reflux and aspiration of gastric contents in anesthetic practice. Anesth Analg. 2001;93:494-513.

Wraight WJ, Chamney AR, Howells TH. The determination of an effective cricoid pressure. Anaesthesia. 1983;38:461-6.

Vanner RG, Pryle BJ. Regurgitation and oesophageal rupture with cricoid pressure: A cadaver study. Anaesthesia. 1992;47:732-5.

Haslam N, Syndercombe A, Zimmer CR, Edmondson L, Duggan JE. Intragastric pressure and its relevance to protective cricoid force. Anaesthesia. 2003;58:1012-5.

Roe RB. The effect of suxamethonium on intragastric pressure. Anaesthesia. 1962;17:179-81.

Turgeon AF, Nicole PC, Trépanier CA, Marcoux S, Lessard MR. Cricoid pressure does not increase the rate of failed intubation by direct laryngoscopy in adults. Anesthesiology. 2005;102:315-9.

McNelis U, Syndercombe A, Harper I, Duggan J. The effect of cricoid pressure on intubation facilitated by the gum elastic bougie. Anaesthesia. 2007;62:456-9.

Koufman JA, Fortson JK, Strong MS. Predictive factors of cricoid ring size in adults in relation to acquired subglottic stenosis. Otolaryngol Head Neck Surg. 1983;91:177-82.

Aoyama K, Takenaka I, Sata T, Shigematsu A. Cricoid pressure impedes positioning and ventilation through the laryngeal mask airway. Can J Anaesth. 1996;43:1035-40.

Weiss M, Gerber AC. Rapid sequence induction in children – It’s not a matter of time! Paediatr Anaesth. 2008;18:97-9.

Vanner RG. Cricoid pressure. Int J Obstet Anesth. 2009;18:103-5.

Crowley DS, Giesecke AH. Bimanual cricoid pressure. Anaesthesia. 1990;45:588-9.

Cook TM. Cricoid pressure: Are two hands better than one? Anaesthesia. 1996;51:365-8.

Strang TI. Does the laryngeal mask airway compromise cricoid pressure? Anaesthesia. 1992;47:829-31.

Asai T, Murao K, Shingu K. Cricoid pressure applied after placement of laryngeal mask impedes subsequent fibreoptic tracheal intubation through mask. Br J Anaesth. 2000;85:256-61.

Hashimoto Y, Asai T, Arai,T, Okuda Y. Effect of cricoid pressure on placement of the I-gel™: A randomised study. Anaesthesia. 2014;69:878-82.

Apfelbaum JL, Hagberg CA, Caplan RA, Blitt CD, Connis RT, Nickinovich DG, et al. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2013;118:251-70.

Salem MR, Wronski CJ, Khorasani A, Crystal GJ. Which is the original and which is the modified rapid sequence induction and intubation? Let history be the judge! Anesth Analg. 2013;116:264-5.

Salem MR, Khorasani A, Saatee S, Crystal GJ, El-Orbany M. Gastric tubes and airway management in patients at risk of aspiration: History, current concepts, and proposal of an algorithm. Anesth Analg. 2014;118:569-79.

Heath KJ, Palmer M, Fletcher SJ. Fracture of the cricoid cartilage after Sellick’s manoeuvre. Br J Anaesth. 1996;76:877-8.

Gabbott DA. The effect of single-handed cricoid pressure on neck movement after applying manual in-line stabilisation. Anaesthesia. 1997;52:586-8.

Brisson P, Brisson M. Variable application and misapplication of cricoid pressure. J Trauma. 2010;69:1182-4.

Armstrong B, Reid C, Heath P, Simpson H, Kitching J, Nicholas J, et al. Rapid sequence induction anaesthesia: A guide for nurses in the emergency department. Int Emerg Nurs. 2009;17:161-8.

Kopka A, Crawford J. Cricoid pressure: A simple, yet effective biofeedback trainer. Eur J Anaesthesiol. 2004;21:443-7.

Flucker CJ, Hart E, Weisz M, Griffiths R, Ruth M. The 50-millilitre syringe as an inexpensive training aid in the application of cricoid pressure. Eur J Anaesthesiol. 2000;17:443-7.

53.Smith CE, Boyer D. Cricoid pressure decreases ease of tracheal intubation using fibreoptic laryngoscopy (WuScope System. Can J Anaesth 2002; 49:614–9 [Article] [PubMed]

Johnson RL, Cannon EK, Mantilla CB, Cook DA. Cricoid pressure training using simulation: A systematic review and meta-analysis. Br J Anaesth. 2013;111:338-46.

Taylor RJ, Smurthwaite G, Mehmood I, Kitchen GB, Baker RD. A cricoid cartilage compression device for the accurate and reproducible application of cricoid pressure. Anaesthesia. 2015;70:18-25.

Lawes EG. Cricoid pressure with or without the “cricoid yoke”. Br J Anaesth. 1986;58:1376-9.

Connor CW, Saffary R, Feliz E. Performance of the Sellick maneuver significantly improves when residents and trained nurses use a visually interactive guidance device in simulation. Physiol Meas. 2013;34:1645-56.

Clayton TJ, Vanner RG. A novel method of measuring cricoid force. Anaesthesia. 2002;57:326-9.

May P, Trethewy C. Practice makes perfect? Evaluation of cricoid pressure task training for use within the algorithm for rapid sequence induction in critical care. Emerg Med Australas. 2007;19:207-12.