title: Ultrasound evaluation of the impact of cricoid pressure versus novel 'paralaryngeal pressure' on anteroposterior oesophageal diameter.
abstract: To assess the degree to which cricoid pressure (Sellick manoeuvre) actually compresses the oesophagus, we measured the effect of cricoid pressure and paralaryngeal pressure on the outer anteroposterior diameter of the upper oesophagus with ultrasound in 39 healthy volunteers. The mean (SD) outer anteroposterior oesophageal diameter was 0.77 (0.11) cm with no pressure, 0.79 (0.13) cm with the application of cricoid pressure of 30 N and 0.68 (0.12) cm with the application of paralaryngeal pressure of 30 N (p < 0.0001). If cricoid pressure does not reduce the anteroposterior diameter of the oesophagus, it is difficult or impossible to explain the efficacy of the Sellick manoeuvre. However, paralaryngeal pressure decreases this diameter and has the potential to occlude the upper oesophagus.
authors: 2nd Department of Anaesthesia and Intensive Care, Warsaw Medical University, Warsaw, Poland.
authors: P
authors: P
authors: Andruszkiewicz
authors: Department of Anaesthesia, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
authors: J
authors: J
authors: Wojtczak
authors: 2nd Department of Anaesthesia and Intensive Care, Warsaw Medical University, Warsaw, Poland.
authors: L
authors: L
authors: Wroblewski
authors: 2nd Department of Anaesthesia and Intensive Care, Warsaw Medical University, Warsaw, Poland.
authors: M
authors: M
authors: Kaczor
authors: Department of Noninvasive Cardiovascular Diagnostics, John Paul 2nd Hospital, Krakow, Poland.
authors: D
authors: D
authors: Sobczyk
authors: Institute of Cardiology, Warsaw, Poland.
authors: I
authors: I
authors: Kowalik
mesh_terms: D000328:Adult; D001837:Body Weights and Measures / Q000379:methods; D003413:Cricoid Cartilage / Q000502:physiology*; D004947:Esophagus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007830:Larynx / Q000502:physiology*; D008297:Male; D011312:Pressure; D011446:Prospective Studies; D012016:Reference Values; D014463:Ultrasonography / Q000379:methods*
keywords: anaesthesia; cricoid pressure; intubation; regurgitation; ultrasound