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UF scientists discover new explanation for controversial old patient-care technique
Date:10/20/2009

GAINESVILLE, Fla. You might not know what it's called, but if you've had general anesthesia before surgery, especially after an accident, it is likely you have received Sellick's maneuver. That's when fingers are pressed against a patient's throat to prevent regurgitation and spilling of stomach contents into the airway and lungs while anesthesia is being administered.

Such regurgitation could result in serious lung damage and even death.

The maneuver is a longstanding practice, first described in 1961 by British physician Brian Sellick. Performed dozens of times a day in hospitals, the procedure is accepted as "standard of care" and is a basic skill taught in all anesthesiology training programs. Anesthesiologists estimate conservatively that more than 100,000 people a year undergo the procedure.

But recently some physicians have begun to question the technique in the wake of a study challenging its effectiveness and ease of execution. And some have stopped using it altogether.

Now, researchers from University of Florida College of Medicine have used magnetic resonance imaging of the neck region to show that the maneuver works and that doubts about its effectiveness are based on a misunderstanding of what physical changes happen in the neck during the procedure.

"Sellick was right that the maneuver works but he was a bit off on the anatomy," said UF anesthesiologist Mark J. Rice, M.D., who led the study now online and to be featured on the cover of the November edition of the journal Anesthesia & Analgesia. The journal will also include two editorials on the controversial topic side by side with the UF paper, which has been selected by the editorial board as this month's graduate medical education article for November.

Also called cricoid pressure, the eponymous maneuver has for decades been described as the pinching of the esophagus between the cricoid a ring of cartilage that surrounds the trach
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Contact: Czerne M. Reid
czerne@ufl.edu
352-273-5810
University of Florida
Source:Eurekalert

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