Sonographic Assessment of Cricoid Pressure

Study Summary

Examining the effectiveness of cricoid pressure using ultrasound imaging. Pulmonary aspiration of gastric contents during tracheal intubation, although rare in pediatrics, is a potentially catastrophic complication of anesthesia. Cricoid pressure is applied during rapid sequence induction to occlude the esophagus and prevent aspiration of gastric contents. Accumulating evidence in adults suggests that cricoid pressure often is not effective, either because the esophagus normally lies lateral to the cricoid cartilage, or because downward pressure on the cricoid cartilage laterally displaces (rather than compresses) the esophagus. The investigator proposes to examine the effectiveness of cricoid pressure in children in the peri-operative setting using non-invasive ultrasound imaging. Using this approach, the investigator will investigate the normal anatomical relationship of the esophagus and the cricoid cartilage, as well as how cricoid pressures influences this relationship. Further, the investigator will examine whether alternatives to downward cricoid pressure, such as laterally directed pressure, are more effective at occluding the esophagus.

Primary Outcome

1. To sonographically assess the diameter of the esophagus before and after application of conventional cricoid pressure 2. To sonographically asses the diameter of the esophagus before and after application of left lateral paralaryngeal pressure

Conditions Studied

Interventions

• OTHER Application of cricoid pressure
• OTHER Application of Left lateral paratracheal pressure

Study Locations (1)