Controversial issue of cricoid pressure or Sellick maneuver

Abstract

Introduction. The Sellick maneuver or cricoid pressure is a procedure that is routinely performed in the prophylaxis for pulmonary aspiration as part of a rapid sequence intubation. It has been considered very controversial specifically on its usefulness as a standard safety practice in the emergent airway management. It usually has been considered a pressure maneuver, however it usually has seen assessed measuring Newtons (N) without considering the area of the cricoid cartilage. For this reason, it must be understood in terms of cricoid force instead of cricoid pressure.

Objetive. To highlight the controversial issues this maneuver has had over the 50 years of its use in airway management and pulmonary aspiration prevention. To explain the common error of describing it in terms of force and not pressure.

Methods. Literature review about the controversial aspects of the Sellick maneuver in emergent scenarios in anesthesia.

Conclusion. Since the initial description by Dr. Brian Arthur Sellick in 1961 of the maneuver, using cricoid pressure to prevent them regurgitation of gastric contents to the pharynx used as part of the rapid sequence induction/ intubation, there have been multiple criticisms worthwhile to review, regarding the safety it provides in protecting the airway. We recommend that the terms pressure and force be differentiated and be used more appropriately when describing the maneuver, as the area of the cartilage should be considered in these measurements.