Services on Demand
Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
MORO, Eduardo Toshiyuki and GOULART, Alexandre. Compression of the cricoid cartilage: current aspects. Rev. Bras. Anestesiol. [online]. 2008, vol.58, n.6, pp. 643-650. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942008000600010.
BACKGROUND AND OBJECTIVES: Sellick described the importance of applying pressure in the cricoid cartilage during anesthesia induction to prevent regurgitation of gastric contents. Since then, the maneuver has been widely accepted by anesthesiologists as a fundamental step during induction with the rapid sequence technique. The objective of the present report was to discuss the indications, technique, complications, and reasons why some authors have refuted the efficacy of this technique. CONTENTS: The indications, technique, and complications of compression of the cricoid cartilage were reviewed. The aspects that have motivated some authors to abandon the Sellick maneuver during anesthetic induction with the rapid sequence technique are also discussed. CONCLUSIONS: The cricoid cartilage pressure maneuver requires knowledge of the anatomy of upper airways and the correct force to be used. Endoscopic and radiologic studies, as well as patients who developed pulmonary aspiration despite the use of Sellick maneuver, have raised doubts about the usefulness of this technique. Besides, can cause deformity of the cricoid cartilage, closure of the vocal cords, and difficulty to ventilate if it is not used properly. Despite the importance given to Sellick maneuver in preventing pulmonary aspiration, there are no guarantees it will protect the airways of all patients, especially when the technique is not properly used.
Keywords : COMPLICATIONS [pulmonary aspiration]; COMPLICATIONS [gastric contents]; INTUBATION, Tracheal [Sellick maneuver]; INTUBATION, Tracheal [rapid sequence].