Awareness and recall after cricoid pressure (Sellick's maneuver) during general anesthesia

Sellick’s maneuver is a routinely used technique for the prevention of pulmonary aspiration of gastric contents during anesthesia. The rationale for the application of cricoid pressure necessitates that it is applied at the loss of consciousness during rapid sequence induction. Cricoid pressure therefore, may be fully applied at a level of anesthesia where awareness, and possibly recall, of the maneuver occurs. This study was setup to determine the frequency of awareness and recall Sellick's maneuver following 100 patients (ASA I, II) who candidates for lower extremity surgery were randomly enrolled in this prospective study. After induction of anesthesia and application of cricoid pressure, symptoms of awareness and recall were recorded. Data were analyzed by SPSS software and Spearman correlation. The frequency of awareness and recall were 45% and 16% respectively. The frequency distribution of awareness severity based on grade 1, 2 and 3 were 16%, 6% and 1% respectively. The frequency distribution of recall severity based on mild, moderate and sever were 15%, zero and 1% respectively. The correlation between awareness severity and recall severity was statistically significant (P<0.05). Due to high frequency of awareness and recall following Sellick's maneuver and its complications, it is advaiable to revise the procedure of this maneuver and inparticular the accurte time in its application.