Moro Eduardo Toshiyuki, Goulart Alexandre
CET-SBA da Faculdade de Medicina, PUC/SP, Sorocaba, SP.
Rev Bras Anestesiol. 2008 Nov-Dec;58(6):646-50, 643-6. doi: 10.1590/s0034-70942008000600010.
Sellick described the importance of applying pressure in the cricoid cartilage during anesthesia induction to prevent regurgitation of gastric contents. Since then, the maneuver has been widely accepted by anesthesiologists as a fundamental step during induction with the rapid sequence technique. The objective of the present report was to discuss the indications, technique, complications, and reasons why some authors have refuted the efficacy of this technique.
The indications, technique, and complications of compression of the cricoid cartilage were reviewed. The aspects that have motivated some authors to abandon the Sellick maneuver during anesthetic induction with the rapid sequence technique are also discussed.
The cricoid cartilage pressure maneuver requires knowledge of the anatomy of upper airways and the correct force to be used. Endoscopic and radiologic studies, as well as patients who developed pulmonary aspiration despite the use of Sellick maneuver, have raised doubts about the usefulness of this technique. Besides, can cause deformity of the cricoid cartilage, closure of the vocal cords, and difficulty to ventilate if it is not used properly. Despite the importance given to Sellick maneuver in preventing pulmonary aspiration, there are no guarantees it will protect the airways of all patients, especially when the technique is not properly used.
塞利克描述了麻醉诱导期间对环状软骨施加压力以防止胃内容物反流的重要性。从那时起，该操作已被麻醉医生广泛接受为快速顺序诱导技术中的基本步骤。本报告的目的是讨论该技术的适应症、操作方法、并发症以及一些作者驳斥其有效性的原因。
回顾了环状软骨压迫的适应症、操作方法和并发症。还讨论了一些作者在快速顺序诱导技术的麻醉诱导过程中放弃塞利克操作的原因。
环状软骨压迫操作需要了解上呼吸道的解剖结构以及正确的用力方式。内镜和放射学研究以及尽管使用了塞利克操作仍发生肺误吸的患者，对该技术的有效性提出了质疑。此外，如果使用不当，可能会导致环状软骨畸形、声带闭合以及通气困难。尽管塞利克操作在预防肺误吸方面很重要，但并不能保证它能保护所有患者的气道，尤其是在技术使用不当的情况下。
