Expert: Ronald Levy, M.D. - 4/17/2009

Question
When receiving my anaesthetic for a recent gallbladder op the nurse pushed into my wind pipe with her fingers while the injection was being given why was this ?

Answer
She did what is called cricoid pressure as part of a rapid sequence induction. You either have a history of reflux or you had acute cholecystitis and you are at risk of aspiration. What a rapid sequence does is it prevents passive aspiration of stomach contents into your lungs because once you go to sleep, you lose your gag reflex which normally does this job for you. Actually the nurse started the cricoid pressure too soon which is why you felt it (and it is uncomfortable). She should have waited until you just fell aslep to do it.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston