تاثير روش هاي مختلف مانور سليك بر نماي لارنگوسكوپي در بيماران تحت جراحي سزارين

Evaluation of different Sellickʹs maneuvers on laryngoscopy view in cesarean section

Background: Cricoid pressure (Sellickʹs maneuver) may alter the laryngoscopy view during tracheal intubation in parturients. Objective: This study was performed to compare the different techniques of Sellickʹs maneuver on laryngoscopy 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.l) 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 Sellicksʹs maneuver. Conclusions: The view at laryngoscopy during cricoid pressure was better than the view without cricoid pressure. The Sellickʹs 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.