The duration of fibre-optic intubation is increased by cricoid pressure. A randomised double-blind study.
BACKGROUND
In some categories of patients, a rapid sequence induction using a fibre-optic method may be indicated. The aim of the present study was to examine the effect of cricoid pressure (CP) on the duration of fibre-optic intubation. The hypothesis was that CP would prolong the intubation time.


METHODS
The study was a randomised, double-blind, cross-over study. The patients were intubated twice, in a randomised way, using a flexible fibrescope once with and once without CP. The intubation time and the visualisation of the glottis were registered. If the intubation was not completed within 180 s, it was registered as failed. CP was standardised to a pressure of 30 N. The data are given as the mean (standard deviation) or median [interquartile] (range).


RESULTS
Fifty patients were included, with a mean age of 53 years (14.6) and mean body mass index of 26.4 (4.3). Three intubations without and 13 intubations with CP failed. The durations of intubation without and with CP were 59 s [53-79 s] (34-144 s) and 75 s [67-104 s] (43-179 s), respectively (P < 0.001).


CONCLUSIONS
The study showed that CP prolongs the duration of fibre-optic intubation in patients with Mallampati grades 1-2.
University of Copenhagen, Glostrup Hospital, Glostrup, Denmark. bjoernarenkiel@hotmail.com
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B
Arenkiel
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M
Smitt
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KS
Olsen
D000328:Adult; D000368:Aged; D003413:Cricoid Cartilage / Q000502:physiology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005931:Glottis / Q000033:anatomy & histology; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055100:Optical Fibers; D010100:Oxygen / Q000097:blood; D011312:Pressure
D010100:Oxygen