Cricoid Pressure Displaces the Esophagus: An Observational Study Using Magnetic Resonance Imaging

@article{Smith2003CricoidPD,
  title={Cricoid Pressure Displaces the Esophagus: An Observational Study Using Magnetic Resonance Imaging},
  author={Kevin J. Smith and Julian Dobranowski and Gordon Yip and Alezandre Dauphin and Peter T.-L. Choi},
  journal={Anesthesiology},
  year={2003},
  volume={99},
  pages={60-64}
}
Background Cricoid pressure (CP) is often used during general anesthesia induction to prevent passive regurgitation of gastric contents. The authors used magnetic resonance imaging to determine the anatomic relationship between the esophagus and the cricoid cartilage (“cricoid”) with and without CP. Methods Magnetic resonance images of the necks of 22 healthy volunteers were reviewed with and without CP. Esophageal and airway dimensions, distance between the midline of the vertebral body and… 

Cricoid cartilage and esophagus: CT scan study of the dynamic variability of their relative positions

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Using Ultrasonography to Assess the Effectiveness of Cricoid Pressure on Esophageal Compression.

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This is the first pediatric study on the rate and degree of esophageal displacement from the airway at the level of the cricoid cartilage andateral displacement occurred at a significantly greater rate in the younger children compared with the older children.

Cricoid Pressure Results in Compression of the Postcricoid Hypopharynx: The Esophageal Position Is Irrelevant

The location and movement of the esophagus is irrelevant to the efficiency of the Sellick’s maneuver (CP) in regard to prevention of gastric regurgitation into the pharynx and compression of the alimentary tract occurs with midline and lateral displacement of the cricoid cartilage relative to the underlying vertebral body.

The Effectiveness of Cricoid Pressure for Occluding the Esophageal Entrance in Anesthetized and Paralyzed Patients: An Experimental and Observational Glidescope Study

The current study provides additional visual and mechanical evidence supporting a success rate of at least 95% by using a cricoid force of 30 N to occlude the esophageal entrance in anesthetized and paralyzed normal adult patients.

Ultrasound Assessment of the Effectiveness of Cricoid Pressure

Application of cricoid pressure during rapid sequence induction to prevent regurgitation of gastric contents shows that CP is useful and effective in occluding the oesophagus even when it is located away from the mid-line and displaced with CP.

What About Compressing the Oesophagus with an Ultrasound Probe for a Modified Sellick Maneuver?

Palaryngeal pressure with an ultrasound probe has the potential to occlude the oesophagus and may be effective in all patient groups, and weak correlation was found between diameter change percentage and neck circumference.

CRICOID PRESSURE : MORE RITUAL THAN EFFECTIVE MEASURE ? 19 RC 3

Backward pressure of the cricoid cartilage against the cervical vertebrae can be used to occlude the oesophagus, to control regurgitation of stomach or oesphageal contents during induction of anaesthesia, or to prevent gastric distension from positive-pressure ventilation applied by facepiece or mouth-to-mouth respiration.

Ultrasound evaluation of cricoid pressure vs. ‘paralaryngeal pressure’ – a reply

References 1. Andruszkiewicz P, Wojtczak J, Wroblewski L, Kaczor M, Sobczyk D, Kowalik I. Ultrasound evaluation of the impact of cricoid pressure versus novel ‘paralaryngeal pressure’ on
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Clinically Oriented Anatomy, 4th Edition