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Ultrasound guided paralaryngeal pressure versus cricoid pressure on the occlusion of esophagus: A crossover study

The primary objective of this study is to compare the effectiveness of cricoid pressure (CP) and paralaryngeal pressure (PLP) on occlusion of eccentric esophagus in patients under general anesthesia (GA). Secondary objectives include the prevalence of patients with central or eccentric esophagus bot...

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Main Authors: Lim, Siu Min, Ng, Boon Keat, Wilson, Aaron, Cheong, Chao Chia, Ng, Tyng Yan, Wang, Chew Yin
Format: Article
Published: Springer 2022
Subjects:
R Medicine (General)
Online Access:http://eprints.um.edu.my/33857/
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spelling my.um.eprints.338572022-04-23T03:39:59Z http://eprints.um.edu.my/33857/ Ultrasound guided paralaryngeal pressure versus cricoid pressure on the occlusion of esophagus: A crossover study Lim, Siu Min Ng, Boon Keat Wilson, Aaron Cheong, Chao Chia Ng, Tyng Yan Wang, Chew Yin R Medicine (General) The primary objective of this study is to compare the effectiveness of cricoid pressure (CP) and paralaryngeal pressure (PLP) on occlusion of eccentric esophagus in patients under general anesthesia (GA). Secondary objectives include the prevalence of patients with central or eccentric esophagus both before and after GA, and the success rate of CP in occluding centrally located esophagus in patients post GA. Fifty-one ASA physical status I and II patients, undergoing GA for elective surgery were enrolled in this study. Ultrasonography imaging were performed to determine the position of the esophagus relative to the trachea: (i) before induction of GA, (ii) after GA before external CP maneuver, (iii) after GA with CP, and (iv) after GA with PLP. CP was applied to all patients whilst PLP via fingertip technique was only applied to patients with an eccentric esophagus. Among a total of 51 patients, 28 of them (55%) had eccentric esophagus pre GA, while this number increase to 33 (65%) after induction of GA. CP success rate was 100% in 18 patients with central esophagus post GA versus 27% in 33 patients with eccentric esophagus post GA (P<0.00001). Overall success rate for CP was 53%. In 33 patients with eccentric esophagus anatomy post GA, PLP success rate was 30% compared with 27% with CP (P=1.000). Ultrasound guided PLP fingertips technique was not effective in patients with an eccentrically located esophagus post GA. Ultrasound guided CP achieved 100% success rate in patients with a centrally located esophagus post GA. Springer 2022-02 Article PeerReviewed Lim, Siu Min and Ng, Boon Keat and Wilson, Aaron and Cheong, Chao Chia and Ng, Tyng Yan and Wang, Chew Yin (2022) Ultrasound guided paralaryngeal pressure versus cricoid pressure on the occlusion of esophagus: A crossover study. Journal of Clinical Monitoring and Computing, 36 (1). pp. 87-92. ISSN 1387-1307, DOI https://doi.org/10.1007/s10877-020-00623-7 <https://doi.org/10.1007/s10877-020-00623-7>. 10.1007/s10877-020-00623-7
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine (General)
spellingShingle R Medicine (General)
Lim, Siu Min
Ng, Boon Keat
Wilson, Aaron
Cheong, Chao Chia
Ng, Tyng Yan
Wang, Chew Yin
Ultrasound guided paralaryngeal pressure versus cricoid pressure on the occlusion of esophagus: A crossover study
description The primary objective of this study is to compare the effectiveness of cricoid pressure (CP) and paralaryngeal pressure (PLP) on occlusion of eccentric esophagus in patients under general anesthesia (GA). Secondary objectives include the prevalence of patients with central or eccentric esophagus both before and after GA, and the success rate of CP in occluding centrally located esophagus in patients post GA. Fifty-one ASA physical status I and II patients, undergoing GA for elective surgery were enrolled in this study. Ultrasonography imaging were performed to determine the position of the esophagus relative to the trachea: (i) before induction of GA, (ii) after GA before external CP maneuver, (iii) after GA with CP, and (iv) after GA with PLP. CP was applied to all patients whilst PLP via fingertip technique was only applied to patients with an eccentric esophagus. Among a total of 51 patients, 28 of them (55%) had eccentric esophagus pre GA, while this number increase to 33 (65%) after induction of GA. CP success rate was 100% in 18 patients with central esophagus post GA versus 27% in 33 patients with eccentric esophagus post GA (P<0.00001). Overall success rate for CP was 53%. In 33 patients with eccentric esophagus anatomy post GA, PLP success rate was 30% compared with 27% with CP (P=1.000). Ultrasound guided PLP fingertips technique was not effective in patients with an eccentrically located esophagus post GA. Ultrasound guided CP achieved 100% success rate in patients with a centrally located esophagus post GA.
format Article
author Lim, Siu Min
Ng, Boon Keat
Wilson, Aaron
Cheong, Chao Chia
Ng, Tyng Yan
Wang, Chew Yin
author_facet Lim, Siu Min
Ng, Boon Keat
Wilson, Aaron
Cheong, Chao Chia
Ng, Tyng Yan
Wang, Chew Yin
author_sort Lim, Siu Min
title Ultrasound guided paralaryngeal pressure versus cricoid pressure on the occlusion of esophagus: A crossover study
title_short Ultrasound guided paralaryngeal pressure versus cricoid pressure on the occlusion of esophagus: A crossover study
title_full Ultrasound guided paralaryngeal pressure versus cricoid pressure on the occlusion of esophagus: A crossover study
title_fullStr Ultrasound guided paralaryngeal pressure versus cricoid pressure on the occlusion of esophagus: A crossover study
title_full_unstemmed Ultrasound guided paralaryngeal pressure versus cricoid pressure on the occlusion of esophagus: A crossover study
title_sort ultrasound guided paralaryngeal pressure versus cricoid pressure on the occlusion of esophagus: a crossover study
publisher Springer
publishDate 2022
url http://eprints.um.edu.my/33857/
_version_ 1735409600265453568
score 13.211869

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