title: The effect of cricoid pressure application on airway patency.
abstract: OBJECTIVE
  To assess the incidence of upper airway obstruction associated with the application of cricoid pressure (Sellick's maneuver) by experienced anesthetists.
  
  
  METHODS
  Randomized, blinded study.
  
  
  METHODS
  Anesthetic rooms at John Radcliffe Hospital, Oxford, United Kingdom.
  
  
  METHODS
  Fifty ASA I patients undergoing routine general anesthesia for elective surgery requiring tracheal intubation.
  
  
  METHODS
  Following induction of anesthesia and muscle relaxation, a senior anesthetist applied cricoia pressure in the manner described by Sellick. Patients were ventilated with or without cricoid pressure, with the order of intervention randomized, and the observer blinded to all maneuvers.
  
  
  RESULTS
  Effect on airway patency was assessed by measuring expired tidal volume (VT) and peak inspiratory pressure (PIP) when ventilated using a face mask with and without cricoid pressure applied, and with and without an oropharyngeal airway in place. Application of cricoid pressure caused a significant reduction in mean expired VT (p < 0.001) and a significant increase in PIP (p < 0.001) compared with control values. Complete airway occlusion occurred in 11% of applications.
  
  
  CONCLUSIONS
  The use of manual cricoid pressure, even by experienced anesthetists, causes a degree of airway obstruction and can cause complete airway occlusion.
authors.affiliation: Nuffield Department of Anaesthetics, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
authors.forename: K G
authors.initials: KG
authors.lastname: Allman
mesh_terms: D000328:Adult; D000403:Airway Resistance; D003413:Cricoid Cartilage; D005260:Female; D006801:Humans; D008297:Male; D011312:Pressure; D016037:Single-Blind Method