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Updated: Jun 24, 2026
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A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
Published on: July 24, 2012
Cervical Spine Movements With Single-Handed Versus Bimanual Cricoid Pressure Under Simulated Cervical Immobilization:
Jeeva Kumar1, Kiran Jangra1, Chirag Ahuja2
1Department of Anaesthesia and Intensive Care.
Journal of Neurosurgical Anesthesiology
|June 23, 2026
Summary
Bimanual cricoid pressure significantly reduces cervical spine movement during intubation with simulated immobilization. This technique improves patient safety by minimizing neck motion without compromising airway access.
Area of Science:
- Anesthesiology
- Emergency Medicine
- Neurosurgery
Background:
- Cricoid pressure is vital in managing patients with full stomachs or during trauma.
- Previous studies on cervical spine movement under cricoid pressure primarily used cadavers.
Purpose of the Study:
- To compare the effectiveness of single-handed versus bimanual cricoid pressure in reducing cervical spine movement.
- To evaluate the impact of bimanual cricoid pressure on intubation conditions.
Main Methods:
- A prospective, randomized, assessor-blind trial involving adult patients undergoing neurointerventional procedures.
- Patients received either single-handed or bimanual cricoid pressure during simulated cervical spine immobilization.
- Cinefluoroscopic imaging assessed angular displacement of cervical vertebrae (C0-C6).
Main Results:
- Bimanual cricoid pressure significantly reduced angular displacement at C4-C5 (0.71° vs. 4.34°, P=0.001).
- Significant reductions in movement were also observed at C1-C2, C2-C3, C3-C4, and C5-C6 with bimanual technique.
- No significant differences were found in laryngoscopic view, intubation time, or hemodynamic responses.
Conclusions:
- Bimanual cricoid pressure effectively minimizes cervical spine movement during simulated immobilization.
- This technique offers improved safety for patients requiring cricoid pressure without hindering intubation.
- Posterior support in bimanual application appears to counteract cricoid pressure-induced spine motion.
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