Efficacy of Cricoid Pressure in preventing Gastric Inflation during Bag-Mask Ventilation in Paediatric Patients.

Salem MR, Wong AY, Mani M, Sellick BA Anaesthesiology 1974 Vol. 40 Pages 96-98

10 patients between the ages of 3 months and 5 years, undergoing elective surgical procedures were studied under anaesthesia and muscle paralysis. In most patients, bag-mask ventilation for a 2-minute period, without cricoid pressure, resulted in appreciable accumulation of gases in the stomach. The investigation indicates that the simple maneuver of gentle cricoid pressure using the middle or little finger of the hand holding the mask, is effective in reducing gastric distension during bag-mask ventilation without interfering with its adequacy. Exhaled volumes were greater during IPPV with cricoid pressure because gases were prevented from entering the esophagus and escaping into the stomach. The authors conclude that use of cricoid pressure during IPPV should not be regarded as a substitute for tracheal intubation, but rather as an alternative in certain situations. It is useful when bag-mask ventilation is carried out for short periods or until tracheal intubation is accomplished.