Effect of cricoid pressure on laryngoscopic view and ease of intubation with Airtraq® laryngoscope

Abstract

Background: Improved laryngeal view has made Airtraq® optical laryngoscope suitable for rapid sequence induction and intubation, provided this important advantage is not lost with application of cricoid pressure (CP). This study was designed to investigate the effect of CP on laryngoscopic view and to ascertain the ease of orotracheal intubation using Airtraq® laryngoscope. Material and Methods: In this prospective randomized study, fifty patients of either gender aged 18-60yrs were randomly allocated into two groups. In Group CP, orotracheal intubation was performed using Airtraq® laryngoscope and application of CP. In Group NCP intubation was performed without application of CP. Laryngoscopic view, success, ease, duration and number of attempts at intubation were recorded. Results: In 49 out of 50 patients included in the study, CP lead to insignificant or no change in POGO score. In Group CP, 21 out of 25 patients had easy intubation, whereas in Group NCP, 23 out of 25 patients had easy intubation. Two patients in both groups had a slightly difficult intubation. Two patients had difficulty in intubation in Group CP, whereas none of the patients in Group NCP had difficulty in intubation. Conclusion: During Airtraq® assisted intubation in patients with normal airways, application of CP does not produce any clinically significant change in the laryngoscopic view and time required for intubation. However, in cases where application of CP causes hindrance in intubation despite adequate laryngeal view, we recommend release of CP to facilitate intubation.