Landsman Ira
Department of Pediatric Anesthesiology, Vanderbilt Children's Hospital, Nashville, TN 37212-1565, USA.
Paediatr Anaesth. 2004 Jan;14(1):43-7. doi: 10.1046/j.1460-9592.2003.01202.x.
Cricoid pressure to occlude the upper end of the oesophagus, also called the Sellick manoeuvre, may be used to decrease the risk of pulmonary aspiration of gastric contents during intubation for rapid induction of anaesthesia. Effective and safe use of the technique requires training and experience. Cricoid pressure is contraindicated in patients with suspected cricotracheal injury, active vomiting, or unstable cervical spine injuries. The technique may be particularly difficult in patients with a history of difficult intubation. The recommended pressure to prevent gastric reflux is between 30 and 40 Newtons (N, equivalent to 3-4 kg), but pressures greater than 20 N cause pain and retching in awake patients and a pressure of 40 N can distort the larynx and complicate intubation. The recommended procedure is, therefore, to induce anaesthesia and apply a pressure of about 30 N, either manually or with the cricoid yoke, to facilitate intubation. Reported complications of cricoid pressure during intubation include oesophageal rupture and exacerbation of unsuspected airway injuries.
压迫环状软骨以阻塞食管上端，也称为塞利克手法，可用于降低快速诱导麻醉插管期间胃内容物肺误吸的风险。有效且安全地使用该技术需要培训和经验。疑似环状软骨气管损伤、活动性呕吐或颈椎损伤不稳定的患者禁忌使用环状软骨压迫法。对于有插管困难病史的患者，该技术可能特别困难。预防胃反流的推荐压力为30至40牛顿（N，相当于3 - 4千克），但大于20 N的压力会使清醒患者感到疼痛和干呕，40 N的压力会使喉部变形并使插管复杂化。因此，推荐的操作是诱导麻醉，并手动或使用环状软骨夹施加约30 N的压力，以利于插管。据报道，插管期间环状软骨压迫的并发症包括食管破裂和未被察觉的气道损伤加重。
