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Pressure measurement in the upper esophagus during cricoid pressure: A high-resolution solid-state manometry study
Richard Pellrud1, Rebecca Ahlstrand1
1Department of Anesthesia and Intensive Care, Örebro University Hospital, Örebro, Sweden.
Acta Anaesthesiologica Scandinavica
|July 6, 2018
Summary
Cricoid pressure during rapid sequence induction creates significant pressure at the upper esophageal sphincter (UES). Further research is needed to confirm its effectiveness in preventing regurgitation before discarding this technique.
Area of Science:
- Anesthesiology
- Gastroenterology
- Esophageal Physiology
Background:
- The efficacy of cricoid pressure in occluding the esophagus is debated.
- This study investigates esophageal pressure changes during cricoid pressure application.
Purpose of the Study:
- To analyze pressure changes in the upper esophagus using high-resolution manometry during cricoid pressure.
- To assess the pressure generated at the upper esophageal sphincter (UES) during modified rapid sequence induction.
Main Methods:
- Secondary analysis of data from a randomized, placebo-controlled, cross-over study.
- Seventeen healthy volunteers underwent modified rapid sequence induction.
- High-resolution solid-state manometry measured esophageal pressures with 30 N cricoid pressure for 15 seconds.
Main Results:
- Cricoid pressure significantly increased pressure at the UES by 123-127 mmHg compared to baseline.
- The pressure difference around the UES was substantial (159-165 mmHg).
Conclusions:
- 30 N cricoid pressure generates high pressures at the UES, potentially exceeding levels needed to prevent regurgitation.
- Further studies are required to determine the clinical effectiveness of cricoid pressure in preventing passive regurgitation during rapid sequence induction.
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