Influence of operating table height on laryngeal view during direct laryngoscopy: A randomized prospective crossover trial. (October 2019)

• Record Type: Journal Article
• Authors: Puri, Kriti; Udupi, Sandesh; Shenoy, Kailasnath; Shenoy, Anitha
• Is Part Of: Trends in anaesthesia and critical care. Volume 28(2019)
• Page Start: 14
• Page End: 18
• Publication Date: 2019-10
• Subjects: Anaesthesiologist -- Operating table -- Patient positioning -- Laryngoscopy -- Endotracheal intubation; Anesthesia -- Periodicals; Critical care medicine -- Periodicals; Anesthesia in traumatology -- Periodicals; Anesthesia -- Case studies -- Periodicals; 617.9605
• DOI: 10.1016/j.tacc.2019.08.003
• Languages: English
• ISSNs: 2210-8440

Abstract

Abstract: Background: Operating table height/patient levelin relation to anaesthesiologist influences mask ventilation, laryngoscopy, intubation and task performance in terms of physical and mental workload. The same was evaluated in this study. Methods: Twenty fivespecialist anaesthesiologists performed mask ventilation and laryngoscopy thrice and intubation once on six patients each, [n = 150] at three different operating table levels (Level X: patient at level of xiphisternum of anaesthesiologist, level A: 5 cms above; level B: 5 cms below xiphisternum). Primary variable was quality of laryngoscopic view obtained. Secondary variables were anaesthesiologist's comfort, ease of performing these tasks and movements at various joints in anaesthesiologist assessed in subjective and objective ways. Results: Laryngoscopic view was best at levels X and A when compared to B ( p = 0.0004). Mask ventilation was most comfortable at level B and least at level A ( p < 0.01). At level B, there was maximum discomfort in 76.6% during laryngoscopy and 60% during intubation ( p < 0.001). Level A had the fastest time (mean ± SD) for both laryngoscopy (8.30s) and intubation (18.3s) ( p < 0.01). Total joint movements were maximal at level B ( p < 0.001). Conclusion: Higher operating table levels are ideal for laryngoscopy and intubation whereas lower levels favour mask ventilation.