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Ultrasound evaluation of the impact of cricoid pressure versus novel ‘paralaryngeal pressure’ on anteroposterior oesophageal diameter
Author(s) -
Andruszkiewicz P.,
Wojtczak J.,
Wroblewski L.,
Kaczor M.,
Sobczyk D.,
Kowalik I.
Publication year - 2016
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13518
Subject(s) - cricoid pressure , medicine , cricoid cartilage , ultrasound , anatomy , ultrasonography , nuclear medicine , surgery , larynx , radiology , intubation
Summary To assess the degree to which cricoid pressure (Sellick manoeuvre) actually compresses the oesophagus, we measured the effect of cricoid pressure and paralaryngeal pressure on the outer anteroposterior diameter of the upper oesophagus with ultrasound in 39 healthy volunteers. The mean ( SD ) outer anteroposterior oesophageal diameter was 0.77 (0.11) cm with no pressure, 0.79 (0.13) cm with the application of cricoid pressure of 30 N and 0.68 (0.12) cm with the application of paralaryngeal pressure of 30 N (p < 0.0001). If cricoid pressure does not reduce the anteroposterior diameter of the oesophagus, it is difficult or impossible to explain the efficacy of the Sellick manoeuvre. However, paralaryngeal pressure decreases this diameter and has the potential to occlude the upper oesophagus.