Impact of Operating Table Height on the Difficulty of Mask Ventilation and Laryngoscopic View

Background/Objectives: Airway management techniques, including mask ventilation and tracheal intubation, are vital across medical settings. However, these procedures can be challenging, especially when environmental conditions are less than ideal. This study explores how the height of the operating table affects the difficulty of surgical procedures involving mask ventilation and tracheal intubation. Methods: Twenty anesthesiologists participated in this study. We assessed the difficulty of procedures- such as mask ventilation, Macintosh laryngoscopy, and video laryngoscopy with McGRATH and AWS- on a four-level scale. The operating table’s height was adjusted at four points: operator's umbilicus, inferior margin of the 12th rib, xiphoid process, and nipple. Results: Mask ventilation was easiest at the operating table’s height aligned with the inferior margin of the 12th rib. Conversely, direct laryngoscopic exposure was perceived easier at higher table heights, with nipple height being optimal. McGRATH laryngoscopy showed consistent difficulty across table height, whereas AWS tended to be somewhat more difficult at greater heights. Conclusions: The optimal bed height for video laryngoscopy coincided with that for mask ventilation. Video laryngoscopy offers enhanced flexibility in optimal patient positioning compared to Macintosh laryngoscopy, contributing to its advantages in tracheal intubation procedures.