CRICOID PRESSURE MAY PREVENT INSERTION OF THE LARYNGEAL MASK AIRWAY

We have studied 42 female patients undergoing elective day-casesurgery allocated randomly to two groups. After induction ofanaesthesia an attempt was made to insert a laryngeal mask airwayafter application of cricoid pressure in one group or with nocricoid pressure in the other. The anaesthetist was unawareof the application, or not, of cricoid pressure. Successfulinsertion was achieved at the first or second attempt in 19of the 22 patients in the non-cricoidpressure group, but inonly three of the 20 patients in the cricoid pressure group(X² 18.62, P <0.001). The laryngeal mask airway was theninserted successfully in all 17 patients after removal of cricoidpressure. The implications of having to remove cricoid pressureif a laryngeal mask airway is to be inserted are discussed.(Br. J. Anaesth. 1992; 69: 465–467)