Do Not Use Cricoid Pressure with the i-gel Airway Device

To determine whether cricoid pressure affects placement or effectiveness of ventilation with the i-gel supraglottic airway device, researchers conducted a randomized crossover study of 40 healthy adults undergoing elective surgery. In each patient, the i-gel was placed by a single experienced investigator with and without application of cricoid pressure. Both cricoid pressure and sham pressure were applied by a trained assistant whose hands were draped.

Adequate ventilation through the i-gel was significantly more successful when cricoid pressure was not applied (100% vs. 85%). Fiber-optic examination showed that the rate of optimal i-gel positioning was also improved without cricoid pressure (98% vs. 43%), as was time to achieve adequate ve…