ures in occluding the esophagus through induction of anesthesia and videolaryngoscopy. METHODS: After the induction of anesthesia in 40 adult patients, the location of the esophageal entrance relative to the glottis and location of the upper esophagus relative to the trachea at the low paratracheal region were assessed using an ultrasonography, and the outer diameter of the esophagus was measured on ultrasound before and during application of cricoid and paratracheal pressures of 30 N. Then, videolaryngoscopy was performed with the application of each pressure. During videolaryngoscopy, location of the esophageal entrance relative to the glottis under cricoid pressure was examined on the screen of videolaryngoscope, and the upper esophagus under paratracheal pressure was evaluated using ultrasound. The occlusion rate of the esophagus, and the best laryngeal view using the percentage of glottic opening scoring system were also assessed during videolaryngsocopy. Esophageal occlusion under each pressure was determined by inserting an esophageal stethoscope into the esophagus. If the esophageal stethoscope could not be advanced into the esophagus under the application of each pressure, the esophagus was regarded to be occluded. RESULTS: During videolaryngoscopy, esophagus was occluded in 40 of 40 (100%) patients with cricoid pressure and 23 of 40 (58%) patients with paratracheal pressure (difference, 42%; 95% confidence interval, 26–58; P < .001). Both cricoid and paratracheal pressures significantly decreased the diameter of the esophagus compared to no intervention in the anesthetized paralyzed state (P < .001, respectively). Ultrasound revealed that the compressed esophagus by paratracheal pressure in the anesthetized paralyzed state was partially released during videolaryngoscopy in 17 of 40 patients, in whom esophageal occlusion was unsuccessful. The best laryngeal view was not significantly different among the no intervention, cricoid pressure, and paratracheal pressure (77 [29] % vs 79 [30] % vs 76 [31] %, respectively; P = .064). CONCLUSIONS: The occlusion of the upper esophagus defined by inability to pass an esophageal stethoscope was more effective with cricoid pressure than with paratracheal pressure during videolaryngoscopy, although both cricoid and paratracheal pressures reduced the diameter of the esophagus on ultrasound in an anesthetized paralyzed state....

中文翻译：

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环状软骨和气管旁压力通过麻醉诱导和可视喉镜封堵上食管的有效性：一项随机交叉研究

通过麻醉诱导和视频喉镜检查封堵食道。方法：对 40 名成年患者进行麻醉诱导后，使用超声评估食管入口相对于声门的位置和上食管相对于气管旁低位气管的位置，以及食管外径在施加 30 N 的环状软骨和气管旁压力之前和期间通过超声测量。然后，在施加每个压力时进行视频喉镜检查。在可视喉镜检查期间，在可视喉镜屏幕上检查环状软骨压力下食管入口相对于声门的位置，并使用超声评估气管旁压力下的上食管。食道的闭塞率，并且在视频喉镜检查期间还评估了使用声门开放评分系统百分比的最佳喉视图。通过将食管听诊器插入食管来确定每个压力下的食管阻塞。如果食管听诊器在每次加压下均不能进入食管，则认为食管已闭塞。结果：在视频喉镜检查期间，40 名环状软骨压迫患者中有 40 名 (100%) 食管被阻塞，40 名气管旁压迫患者中有 23 名 (58%) 食管被阻塞（差异，42%；95% 置信区间，26–58；P < . 001). 与麻醉瘫痪状态下的无干预相比，环状软骨和气管旁压力显着降低了食管的直径（分别为 P < .001）。超声显示，在 40 例食管封堵失败的患者中，有 17 例在麻醉麻痹状态下气管旁压力压迫的食管在可视喉镜检查中部分释放。最佳喉视图在无干预、环状软骨压力和气管旁压力之间没有显着差异（分别为 77 [29] % 对 79 [30] % 对 76 [31] %；P = .064）。结论：在视频喉镜检查期间，环状软骨压力比气管旁压力更有效地定义为无法通过食管听诊器的上食管闭塞，尽管在麻醉麻痹状态下环状软骨和气管旁压力均减小了超声显示的食管直径。 ..