Document Detail


Effect of cricoid pressure on the ease of fibrescope-aided tracheal intubation.
MedLine Citation:
PMID:  12190757     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We studied the reasons for difficulty with tracheal intubation over a fibrescope, and whether cricoid pressure facilitated intubation, in 50 patients. After induction of anaesthesia and neuromuscular blockade in 10 patients (phase 1), we attempted to clarify the reasons for difficulty in advancing a tracheal tube over an orally-inserted fibrescope, by observing through another fibrescope that was inserted nasally into the pharynx. In the next 40 patients (phase 2), we studied the effect of cricoid pressure on the success rate of tracheal intubation over the fibrescope. After a fibrescope (with a tracheal tube over it) had been inserted orally into the trachea, patients were randomly allocated to receive either criocoid pressure or sham pressure, and the success rate of intubation within 60 s was assessed. In phase 1, the tube was advanced into the trachea without difficulty in three of 10 patients. In the remaining seven patients, the tube impacted on the epiglottis in one patient and on the arytenoid cartilage in another two patients, and the tube migrated into the hypopharynx in the remaining four patients. In phase 2, tracheal intubation was successful within 60 s in seven of 21 patients (33%) without cricoid pressure, compared with 12 of 19 patients (63%) when cricoid pressure was applied (95% CI for difference 2-59%; p = 0.04). We conclude that cricoid pressure facilitates fibrescope-aided tracheal intubation.
Authors:
T Asai; K Murao; S Johmura; K Shingu
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anaesthesia     Volume:  57     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-08-22     Completed Date:  2002-10-04     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  909-13     Citation Subset:  AIM; IM    
Affiliation:
Department of Anaesthesiology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi City, Osaka, 570-8507, Japan. asait@takii.kmu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cricoid Cartilage*
Fiber Optic Technology*
Humans
Intubation, Intratracheal / methods*
Middle Aged
Pressure

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