This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the non-inferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in pregnant women and outside the operating room. Although this study failed to demonstrate non-inferiority of sham cricoid pressure to cricoid pressure the data does not show any hint that cricoid pressure is the better approach. In fact, there was a significant difference in terms of difficulty of intubation favoring no application of cricoid pressure and, the difficulty in view was relieved in most cases by removing cricoid pressure. Cricoid pressure should not routinely be provided to patients undergoing intubation.

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