THE EFFECTS OF SINGLE-HANDED AND BIMANUAL CRICOID PRESSURE ON THE VIEW AT LARYNGOSCOPY

The effects of two different methods of cricoid pressure on laryngosco pic view were studied in 94 healthy women presenting for routine gynae cological surgery. Laryngoscopy was performed with either single-hande d or bimanual cricoid pressure; after grading of the view obtained, th e other method was used and a second grading performed. Laryngoscopic view was better with the bimanual than with the single-handed techniqu e (p = 0.016). In 21 cases, a better laryngoscopic view was obtained w ith the bimanual technique; in eight cases it was better with the sing le-handed technique; and in 65 cases, the method of cricoid pressure m ade no difference. Age, weight, Mallampatti score and thyromental dist ance did not differ between patients in these three groups. Bimanual c ricoid pressure,should be the initial technique of choice during rapid sequence induction but, in a minority of cases, switching to a single -handed technique may improve the laryngoscopic view. The technique of cricoid pressure which produces the best laryngoscopic view in an ind ividual patient cannot be predicted from the physical features studied .