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Comparing the effects of ' Cricoid pressure' or 'Paralaryngeal pressure' during endotracheal intubation procedure.
Applying Cricoid pressure is widely used procedure to prevent gastric contents regurgitation during endotracheal intubation. To find out effectiveness external pressure is applied, the investigators will evaluate the relative position of esophagus and trachea. And also comparing the effects of Cricoid pressure and Paralaryngeal pressure during whole tracheal intubation procedures.
1) Awake states. (Before sedation) 2) Anesthetized states. (After muscle relaxation) 3) During direct intubation procedure.
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| Measure | Description | Time Frame |
|---|---|---|
| Occlusion of esophagus | Occlusion of esophagus is checked under the application of cricoid and paralaryngeal pressures during direct laryngsocpy | for 1 minute during direct laryngosopy |
| Measure | Description | Time Frame |
|---|---|---|
| The relative position of the upper esophageal end to the glottis | The position assessed by using ultrasonography and direct visualization | 1 minute before and after the induction of anesthesia, during direct laryngoscopy |
| The outer anteroposterior diameter of the upper esophageal end |
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Inclusion Criteria:
Exclusion Criteria:
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Who has any surgery under general anesthesia and agree with the purpose of the study
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul Metropolitan Government Seoul National University Boramae Medical Center | Seoul | 156-707 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 8424572 | Background | Warner MA, Warner ME, Weber JG. Clinical significance of pulmonary aspiration during the perioperative period. Anesthesiology. 1993 Jan;78(1):56-62. doi: 10.1097/00000542-199301000-00010. | |
| 17122571 | Background | Lienhart A, Auroy Y, Pequignot F, Benhamou D, Warszawski J, Bovet M, Jougla E. Survey of anesthesia-related mortality in France. Anesthesiology. 2006 Dec;105(6):1087-97. doi: 10.1097/00000542-200612000-00008. |
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The outer anteroposterior diameter of the upper esophageal end is assessed before and durng the application of cricoid and paralaryngeal pressures. |
| During 1 minute in awake and anesthetized paralyzed states |
| POGO score | POGO score under the application of cricoid and paralaryngeal pressures | during direct laryngoscopy |
| 21287147 | Background | Koenig SJ, Lakticova V, Mayo PH. Utility of ultrasonography for detection of gastric fluid during urgent endotracheal intubation. Intensive Care Med. 2011 Apr;37(4):627-31. doi: 10.1007/s00134-010-2125-9. Epub 2011 Feb 2. |