Use of cricoid pressure during rapid sequence induction: Facts and fiction

SummaryCricoid pressure (CP) was introduced into anaesthetic practice based on a single case series that lacked information on the force applied and on the method of application. Up to now, there are no controlled, prospective randomised trials which document that CP pressure reduces the incidence of regurgitation of gastric content and pulmonary aspiration. On the other hand, numerous studies have shown that CP has multiple adverse effects, the most important one being interference with airway management. In addition, numerous surveys have shown that most anaesthetists lack adequate knowledge about all aspects of CP. Despite lack of evidence for its beneficial effect, CP is still considered by many anaesthetists an integral part of any rapid sequence induction of anaesthesia.