Evaluation of different Sellick’s maneuvers on laryngoscopic view in cesarean

Background: Cricoid pressure (Sellick’s maneuver) may alter the laryngoscopic view during tracheal intubation in parturients. Objective: This study was performed to compare the different techniques of Sellick’s maneuver on laryngoscopic view in cesarean section. Methods: This was a clinical-trial performed on 142 parturients, aged 18-45 years of ASA I, and II undergoing elective cesarean section. Patients were randomly divided into 4 groups based on type of CP.1) In this group the cricoid pressure was performed using the index finger over the cricoid cartilage while the thumb and middle finger either side, in group 2) with the index and middle fingers over the cricoid cartilage while the palm of hand over sternum, in group3) with one hand behind the neck while the index finger over the cricoid cartilage and the thumb and middle fingers either side, and in group4) similar to the technique used for group C as well as using a pillow behind the head. Laryngoscopic view was determined following induction, laryngoscopy and CP. Data was analysed with spirmann, ANOVA, krusskal wallis, and X2 tests. Findings: A better laryngoscopic view was found in group 1 followed by 3, 4, and 2, respectively. There was significant differences between 4 groups based on laryngoscopic view changes (p= 0.02). No intubation failure in patients was observed during Sellicks’s maneuver. Conclusions: The view at laryngoscopy during cricoid pressure was better than the view without cricoid pressure. The Sellick’s maneuver in which downward pressure was applied with the left index finger over the cricoid cartilage and the thumb and middle fingers either side could produce the best laryngoscopic view in parturients undergoing cesarean section.