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Cricoid yoke: the effect of surface area and applied force on discomfort experienced by conscious volunteers

 

作者: A. Campbell,   A. Turley,   A. Wilkes,   J. Hall,  

 

期刊: European Journal of Anaesthesiology  (OVID Available online 2003)
卷期: Volume 20, issue 1  

页码: 52-55

 

ISSN:0265-0215

 

年代: 2003

 

出版商: OVID

 

关键词: ANAESTHESIA, general;ANAESTHESIA, obstetrical;LARYNGEAL CARTILAGES, cricoid cartilage

 

数据来源: OVID

 

摘要:

Background and objective:The application of cricoid force is central to techniques that reduce the risk of gastric regurgitation and the subsequent pulmonary aspiration associated with obstetric and emergency anaesthesia. The discomfort associated with cricoid force in awake preoperative patients increases the incidence of coughing, struggling and pain during induction of anaesthesia. This study determined if increasing the surface area of a cricoid yoke reduced the associated discomfort in volunteers.Methods:Fifty volunteers participated in a randomized single-blinded study. The cricoid yoke was positioned using standard anatomical landmarks and forces of 10, 20, 30 and 40 N were applied in a random order for 20 s, using two different yoke attachments with surface areas of 3 and 10 cm2. A rest of 30 s was allowed between the application of forces. Discomfort was graded by volunteers on a scale from 0 to 10 (0: no discomfort; 10: worse discomfort imaginable). A score of 10 was allocated if the volunteers could not tolerate the applied force for 20 s.Results:Median scores for the small yoke were always higher than those for the large yoke at each force. There were significant differences between the scores for the small and large yokes at 10 and 20 N (P< 0.001) and 30 N (P= 0.0233), but there was no significant difference at 40 N.Conclusions:The larger yoke was tolerated better by volunteers when clinically relevant cricoid forces were applied.

 

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