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Intragastric pressure and its relevance to protective cricoid force
N Haslam1, A Syndercombe, C R Zimmer
1Department of Anaesthetics, Wansbeck General Hospital, Woodhorn Lane, Ashington NE63 9JJ, UK. nhaslam@doctors.org.uk
Anaesthesia
|September 13, 2003
Summary
Cricoid pressure is vital for preventing regurgitation in anesthetized patients. This study measured intragastric pressure (Pga) during ventilation, finding it varies and is not linked to BMI, informing cricoid force application.
Area of Science:
- Anesthesiology
- Physiology
Background:
- Cricoid pressure is a standard technique to prevent passive regurgitation in anesthetized patients.
- Intragastric pressure (Pga) is the primary driver of regurgitation, but its role during cricoid force application is understudied.
Purpose of the Study:
- To determine the typical range of intragastric pressure (Pga) in patients at risk of regurgitation during anesthesia.
- To assess the relationship between Pga and body mass index (BMI).
Main Methods:
- Studied 100 consecutive surgical patients requiring mechanical ventilation.
- Measured respiratory swings in Pga during mechanical ventilation in paralyzed patients post-induction.
- Analyzed Pga at end-inspiration (Pga-In) and end-expiration (Pga-Ex).
Main Results:
- Mean Pga-In was 6.48 (2.60) mmHg and mean Pga-Ex was 3.23 (2.24) mmHg across all patients.
- No significant correlation was found between Pga and body mass index (r² = 0.018).
Conclusions:
- The measured intragastric pressures provide a baseline for understanding regurgitation risk during anesthesia.
- Findings suggest that the level of cricoid force needed may need to account for the dynamic Pga, independent of BMI.
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