Airway Manoeuvers - Implications for Airway Management?

The Effect of Cricoid Pressure and Backward Upward Rightward Pressure on Airway Dimensions - Implications for Airway Management?

In anesthesia, intubation is a technique used to secure an airway. This technique is not always straightforward. Sometimes it is difficult to place an endotracheal tube. There are two manners of giving pressure to the patients neck, to improve view and facilitate intubation.

The investigators hypothesize that by giving this pressure the effective work area is likely to be smaller. The investigators would like to quantify this effect by measuring the effective work area, using a specially designed computer program.

Study Overview

• Status: Completed
• Conditions: Airway Management

Detailed Description

Cricoid pressure (CP) and the backward-upward-rightward pressure (BURP) manoeuver, are extralaryngeal manoeuvers which are widely applied during endotracheal intubation, respectively offering potential protection against passive gastric regurgitation and improved laryngeal view in emergency airway management.

Their validity in achieving an improvement of the laryngeal view has been questioned.

The objective of this study is to measure the change in mean anterior-posterior rima glottidis (APRIMA) distance and mean area under the vocal cords after backward upward rightward pressure (BURP) and cricoid pressure (CP).

The investigators will measure the APRIMA distances and areas under the vocal cords, using a specially created module in the program DeVIDE. The measurements assessed during BURP and CP will be expressed relative to the measurements when no external pressure is applied.

• Study Type: Observational
• Enrollment (Actual): 200

Contacts and Locations

Study Locations

• Netherlands
  • Eindhoven, Netherlands, 5623 EJ
    • Catharina Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

200 consecutive adult patients scheduled for elective surgery requiring endotracheal intubation.

Description

Inclusion Criteria:

- 200 consecutive adult patients scheduled for elective surgery requiring endotracheal intubation

Exclusion Criteria:

• BMI > 35 kg.m-2);
• chronic obstructive pulmonary disease;
• history of difficult intubation;
• mouth opening < 3 cm;
• inadequate neck mobility;
• history of oropharyngeal pathology.

Study Plan

How is the study designed?

Collaborators and Investigators

• Sponsor: Catharina Ziekenhuis Eindhoven

Study record dates

Study Major Dates

• Study Start: June 1, 2011
• Primary Completion (Actual): July 1, 2011
• Study Completion (Actual): July 1, 2011

Study Registration Dates

• First Submitted: September 3, 2012
• First Submitted That Met QC Criteria: September 3, 2012
• First Posted (Estimate): September 6, 2012

Study Record Updates

• Last Update Posted (Estimate): September 7, 2012
• Last Update Submitted That Met QC Criteria: September 6, 2012
• Last Verified: September 1, 2012

More Information

Terms related to this study

• Keywords: cricoid pressure (CP); backward upward rightward pressure (BURP); AP-rima distances; Glottic area; Extralaryngeal manoeuvres
• Other Study ID Numbers: 2011-06