The “BURP” maneuver worsens the glottic view when applied in combination with cricoid pressure

  title={The “BURP” maneuver worsens the glottic view when applied in combination with cricoid pressure},
  author={Douglas D Snider and Donna Clarke and Brendan T Finucane},
  journal={Canadian Journal of Anesthesia},
PurposeThe purpose of this study was to determine if the application of a BURP maneuver to the cricoid cartilage would combine the benefits of both the BURP and the Sellick maneuvers, resulting in an improved glottic view and offer the potential of protection against passive gastric regurgitation.MethodsThis was a double-blind, prospective, randomized, crossover trial. Forty-three patients scheduled for elective surgery participated in this study. General anesthesia was induced using fentanyl… Expand
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Paratracheal pressure was noninferior to cricoid pressure with respect to the effect on glottic view during direct laryngoscopy with a randomized, double-blind, non inferiority trial. Expand
Comparison of laryngoscopic view and intubation conditions in "BURP" and "Modified BURP" maneuvers
Findings of this study indicate that modified BURP provides better view of laryngoscopy compared to BURP, and both methods and maneuvers are equally effective regarding the success of intubation. Expand
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Using a cadaver model, bimanual laryngoscopy improved the view compared to cricoid pressure, BURP, and no manipulation, and should be considered when teaching emergency airway management. Expand
Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia: The IRIS Randomized Clinical Trial
This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the noninferiority of the sham procedure in preventing pulmonary aspiration, although the comparison of the Cormack and Lehane grade suggest an increased difficulty of tracheal intubation in the Sellick group. Expand
Effect of Cricoid Pressure on Laryngeal View During Macintosh, McGrath MAC X-Blade and GlideScope Video Laryngoscopies.
Although all three devices are useful for normal or difficult intubation, cricoid pressure improved Cormack-Lehane grades of Macintosh and McGrath MAC X-Blade video laryngoscopes but statistically significantly worsened that of the GlideScope video lARYngoscope. Expand
Comparison of bimanual laryngoscopy, backward-rightward pressure, and cricoid pressure in difficult airway management: A manikin study
Backward-rightward pressure may be the most efficient method of external laryngeal manipulation on the basis of the intubation time and improvemen t in glottic view. Expand
Improving the C-MAC Video Laryngoscopic view when Applying Cricoid Pressure by allowing access of Assistant to the Video Screen
The findings suggest that assistants applying cricoid pressure when a C-MAC is used should have access to the video image, but must also respond to requests for change from the person performing the intubation. Expand
Compressão da Cartilagem Cricóide. Aspectos Atuais* Compression of the Cricoid Cartilage. Current Aspects
The objective of the present report was to discuss the indications, technique, complications, and reasons why some authors have refuted the efficacy of the Sellick maneuver during anesthetic induction with the rapid sequence technique. Expand
Comments on comparison of tracheal intubation using Airway scope and Macintosh laryngoscope in patients with simulated limitation of neck movements.
In this study, Adnet’s Intubation Difficulty Scale (IDS) score was used as a primary outcome and there is no evidence to support existence of significant association between IDS scores and ease or success rates of tracheal intubation. Expand
Cricoid pressure – A misnomer in pediatric anaesthesia
In ‘Modified BURP’ maneuver’, the patient lies supine with a sniffing position. The thumb and middle finger are applied to the cricoid cartilage and the index finger is applied to the left hand sideExpand


The Efficacy of the "BURP" Maneuver During a Difficult Laryngoscopy
It is concluded that the BURP maneuver improved the visualization of the larynx more easily than simple back pressure on the laryngoscopy. Expand
Quantitative improvement in laryngoscopic view by optimal external laryngeal manipulation.
OELM can improve the laryngoscopic view by at least one whole grade and should be an instinctive and reflex response to any "A" of 2, 3, or 4, and the best way to determine OELM for an individual patient is on an empirical basis by manipulation of the larynx. Expand
Difficult laryngoscopy made easy with a “BURP”
  • R. Knill
  • Medicine
  • Canadian journal of anaesthesia = Journal canadien d'anesthesie
  • 1993
In a patient with the Treacher-Collins syndrome in whom conventional laryngoscopy had proved impossible and tracheal intubation extremely difficult, this manoeuvre exposed the entire glottis and made tracheo-intubation under direct vision easy. Expand
Assessing the force generated with application of cricoid pressure.
Findings of this study suggest perioperative nurses lack both knowledge and clinical skill for generating effective amounts of cricoid force. Expand
Use of a mechanical simulator for training in applying cricoid pressure.
It is concluded that the majority of untrained personnel apply inadequate cricoid force, placing patients at risk of aspiration of gastric contents and a simple training programme improved application of cricoids force. Expand
Two patients died after inhalation of gastric contents during general anaesthesia for caesarean section. Both had received antacid therapy before surgery and their stomachs contained large volumes ofExpand