Cricoid pressure impedes placement of the laryngeal mask airway. 1995

T Asai, and K Barclay, and I Power, and R S Vaughan
Department of Anaesthetics and Intensive Care Medicine, University of Wales College of Medicine, Heath Park, Cardiff.

We have studied 22 patients to examine whether or not cricoid pressure affects ventilation of the lungs via the laryngeal mask and its correct positioning. In a randomized, crossover design, the laryngeal mask was inserted with or without cricoid pressure applied with a standardized force of 30 N using a cricoid yoke. A standardized pillow (6 cm in height) was placed under the patient's occiput, but the neck was not supported. Ventilation of the lungs via the laryngeal mask was adequate in all patients when no cricoid pressure was applied, but in only three of 22 patients when cricoid pressure was applied (P << 0.001; 95% confidence interval (CI) 0.72-1.0). The mask was positioned correctly in 18 patients when no pressure was applied, and in none after application of cricoid pressure (P << 0.001; 95% CI 0.66-0.98). We had planned to study, in an additional 20 patients, the effect of cricoid pressure without a pillow under the occiput; placement of the mask, however, was difficult even when cricoid pressure was not applied and there was a high incidence of bleeding from the oropharynx. We thus abandoned that part of the study after eight patients. In those eight patients, the success rate of ventilation via the laryngeal mask was lower when cricoid pressure was applied. We conclude that when sufficient force was applied, cricoid pressure, regardless of the method of application, did impede placement of the laryngeal mask.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011015 Pneumonia, Aspiration A type of lung inflammation resulting from the aspiration of food, liquid, or gastric contents into the upper RESPIRATORY TRACT. Acid Aspiration Syndrome,Aspiration Pneumonia,Gastric Acid Aspiration Syndrome,Mendelson Syndrome,Mendelson's Syndrome,Acid Aspiration Syndromes,Aspiration Pneumonias,Mendelsons Syndrome,Pneumonias, Aspiration,Syndrome, Acid Aspiration,Syndrome, Mendelson,Syndrome, Mendelson's,Syndromes, Acid Aspiration
D011312 Pressure A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Pressures
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D003413 Cricoid Cartilage The small thick cartilage that forms the lower and posterior parts of the laryngeal wall. Cartilage, Cricoid,Cartilages, Cricoid,Cricoid Cartilages
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001512 Bedding and Linens Articles of cloth, usually cotton or rayon and other synthetic or cotton-blend fabrics, used in households, hospitals, physicians' examining rooms, nursing homes, etc., for sheets, pillow cases, toweling, gowns, drapes, and the like. Linens,Bedding,Beddings,Linen,Linens and Bedding
D017214 Laryngeal Masks A type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anesthesia in certain patients. It is introduced into the hypopharynx to form a seal around the larynx thus permitting spontaneous or positive pressure ventilation without penetration of the larynx or esophagus. It is used in place of a facemask in routine anesthesia. The advantages over standard mask anesthesia are better airway control, minimal anesthetic gas leakage, a secure airway during patient transport to the recovery area, and minimal postoperative problems. Laryngeal Mask Airway,Airway, Laryngeal Mask,Airways, Laryngeal Mask,Laryngeal Mask,Laryngeal Mask Airways,Mask, Laryngeal,Masks, Laryngeal

Related Publications

T Asai, and K Barclay, and I Power, and R S Vaughan
October 1996, Canadian journal of anaesthesia = Journal canadien d'anesthesie,
T Asai, and K Barclay, and I Power, and R S Vaughan
August 2000, British journal of anaesthesia,
T Asai, and K Barclay, and I Power, and R S Vaughan
May 1993, British journal of anaesthesia,
T Asai, and K Barclay, and I Power, and R S Vaughan
May 1993, British journal of anaesthesia,
T Asai, and K Barclay, and I Power, and R S Vaughan
November 1991, Anaesthesia,
T Asai, and K Barclay, and I Power, and R S Vaughan
October 1997, AANA journal,
T Asai, and K Barclay, and I Power, and R S Vaughan
October 1992, Anaesthesia,
T Asai, and K Barclay, and I Power, and R S Vaughan
March 1994, Anesthesia and analgesia,
T Asai, and K Barclay, and I Power, and R S Vaughan
November 1992, British journal of anaesthesia,
Copied contents to your clipboard!