British Journal of Anaesthesia, Vol 76, Issue 6 772-776, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
T. Asai, K. Barclay, C. McBeth and R. S. Vaughan
We studied 50 patients, in a blind, crossover study, to assess if cricoid
pressure applied after placement of the laryngeal mask prevented gastric
insufflation without affecting ventilation. After induction of anaesthesia
and neuromuscular block, a laryngeal mask was inserted and confirmed to be
placed correctly. The lungs were ventilated with a maximum inflation
pressure of 15 cm H2O. In the first 25 patients, expiratory volumes were
measured with and without cricoid pressure (30 N). On both occasions, a
free hand was placed under the patient's neck. In the next 25 patients, the
effect of cricoid pressure on ventilation without support of the neck was
also studied. The effect of cricoid pressure with support of the neck on
gastric insufflation was then assessed using a stethoscope in all 50
patients, while the lungs were ventilated with a maximum inflation pressure
of 30 cm H2O. At the end of the study, the position of the mask was
re-assessed. Cricoid pressure significantly decreased mean expiratory
volume (P << 0.001). This inhibitory effect was significantly greater
when the pressure was applied without support of the neck (P <<
0.001). Cricoid pressure significantly reduced the incidence of gastric
insufflation (12 patients vs one patient; P << 0.001; 95% CI for
difference 10.5- 33.5%). In no patient was the mask dislodged after these
procedures. Thus, although cricoid pressure applied after insertion of the
laryngeal mask prevented gastric insufflation, it also decreased
ventilation. The inhibitory effect of cricoid pressure on ventilation
without support of the neck was greater than cricoid pressure with support
of the neck.
CLINICAL INVESTIGATIONS
Cricoid pressure applied after placement of the laryngeal mask prevents gastric insufflation but inhibits ventilation
Department of Anaesthetics and Intensive Care Medicine, University of Wales College of Medicine, Heath Park, Cardiff CF4 4XW
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C. W. Li, F. S. Xue, Y. C. Xu, Y. Liu, P. Mao, K. P. Liu, Q. Y. Yang, G. H. Zhang, and H. T. Sun Cricoid Pressure Impedes Insertion of, and Ventilation Through, the ProSeal Laryngeal Mask Airway in Anesthetized, Paralyzed Patients Anesth. Analg., May 1, 2007; 104(5): 1195 - 1198. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Asai, A. Kawashima, I. Hidaka, and S. Kawachi The laryngeal tube compared with the laryngeal mask: insertion, gas leak pressure and gastric insufflation Br. J. Anaesth., November 1, 2002; 89(5): 729 - 732. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S D Carley, C Gwinnutt, J Butler, I Sammy, and P Driscoll Rapid sequence induction in the emergency department: a strategy for failure Emerg. Med. J., March 1, 2002; 19(2): 109 - 113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ng and G. Smith Gastroesophageal Reflux and Aspiration of Gastric Contents in Anesthetic Practice Anesth. Analg., August 1, 2001; 93(2): 494 - 513. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Asai, K. Murao, and K. Shingu Cricoid pressure applied after placement of laryngeal mask impedes subsequent fibreoptic tracheal intubation through mask{dagger} Br. J. Anaesth., August 1, 2000; 85(2): 256 - 261. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Bryden and C. Gwinnutt Airway management: the difficult airway Trauma, April 1, 2000; 2(2): 113 - 123. [Abstract] [PDF]
|
|