Effect of table height on supraglottic airway insertion (I-gel): A randomized control trial

Abstract

Both operating table height and patient level in relation to the anesthesiologist influence supraglottic airway device (SAD) insertion and task performance in terms of physical and mental workload. The aim of the study was to find out the appropriate table height during SAD insertion in terms of time taken for insertion, success rate, ease of insertion, and anesthesiologist comfort. In this randomized controlled trial, 90 American Society of Anesthesiologists physical status I and II patients, aged between 18 and 60 years, scheduled for elective surgery were recruited. Patients were divided into three groups of 30 each. During SAD insertion, the table height was adjusted so that the patient’s forehead was at the level of 5 cm above the xiphoid process in group I, at the level of the xiphoid process in group II, and at the level of 5 cm below the xiphoid process in group III of the anesthesiologist. We measured SAD insertion time, first attempt success rate, ease of insertion, and anesthesiologist comfort during the procedure. The SAD insertion time (in seconds) was lower in group III than in groups I and II, and a significant difference was found between the groups (P < 0.05). The mean ease of insertion score, anesthesiologist comfort, and the first-attempt success rate of SAD insertion were higher in group III than in groups I and II, and the difference among the groups was statistically significant (P < 0.05). We conclude that the lower table height with the patient’s forehead at the level of 5 cm below the xiphoid process of the anesthesiologist is ergonomically more efficient during SAD (I-gel) insertion. This table height is also more comfortable for the anesthesiologist during SAD placement.