PMID- 17573388
OWN - NLM
STAT- MEDLINE
DCOM- 20070821
LR  - 20180126
IS  - 0007-0912 (Print)
IS  - 0007-0912 (Linking)
VI  - 99
IP  - 2
DP  - 2007 Aug
TI  - Cricoid pressure prevents placement of the laryngeal tube and laryngeal 
      tube-suction II.
PG  - 282-5
AB  - BACKGROUND: The laryngeal tube has a potential role in patients with a difficult 
      airway, but cricoid pressure is required if the patient is at risk of aspiration. 
      The effect of cricoid pressure on insertion of these devices is unknown. METHODS: 
      In a randomized cross-over study, the laryngeal tube (25 patients) or the 
      laryngeal tube-suction II (15 patients) was inserted with cricoid pressure 
      applied on one occasion and with sham pressure on the other occasion. Adequacy of 
      ventilation, time to achieve adequate ventilation, and the leak pressure were 
      assessed. RESULTS: Ventilation was adequate in all patients when sham pressure 
      was applied. Cricoid pressure significantly reduced the rate of adequate 
      ventilation to 6 of 25 patients for the laryngeal tube [P < 0.001; 95% confidence 
      interval (CI) for difference: 59-93%] and to 5 of 15 patients for the laryngeal 
      tube-suction II (P < 0.05; 95% CI for difference: 43-91%). The median time taken 
      to achieve adequate ventilation for the laryngeal tube was 10 s [inter-quartile 
      range (IQR): 8-15] (range 5-26) for sham pressure and 25 s (15-32) (15-33) for 
      cricoid pressure; the median leak pressure was 30 (IQR: 30-30) (range 20-30) cm 
      H2O for sham pressure and 15.5 (14.3-20.5) (12-22) cm H2O for cricoid pressure. 
      CONCLUSIONS: Continuous cricoid pressure prevents correct placement of the 
      laryngeal tube and the laryngeal tube-suction II such that placement and 
      ventilation via these devices are ineffective. The effect of cricoid pressure on 
      ventilation via these devices, after correct placement, remains unknown.
FAU - Asai, T
AU  - Asai T
AD  - Department of Anesthesiology, Kansai Medical University, Osaka, Japan.
FAU - Goy, R W L
AU  - Goy RW
FAU - Liu, E H C
AU  - Liu EH
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20070615
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
SB  - IM
MH  - Adult
MH  - Aged
MH  - Airway Obstruction/*etiology
MH  - *Cricoid Cartilage
MH  - Cross-Over Studies
MH  - Equipment Design
MH  - Female
MH  - Humans
MH  - Intubation, Intratracheal/methods
MH  - *Laryngeal Masks/adverse effects
MH  - Male
MH  - Middle Aged
MH  - Pneumonia, Aspiration/prevention & control
MH  - Pressure
MH  - Suction
EDAT- 2007/06/19 09:00
MHDA- 2007/08/22 09:00
CRDT- 2007/06/19 09:00
PHST- 2007/06/19 09:00 [pubmed]
PHST- 2007/08/22 09:00 [medline]
PHST- 2007/06/19 09:00 [entrez]
AID - S0007-0912(17)34769-4 [pii]
AID - 10.1093/bja/aem159 [doi]
PST - ppublish
SO  - Br J Anaesth. 2007 Aug;99(2):282-5. doi: 10.1093/bja/aem159. Epub 2007 Jun 15.