{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:43:59Z","timestamp":1786653839481,"version":"build-2736575974"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,6]]},"abstract":"\n Background and Aims:<\/jats:title>\n The head-elevated laryngoscopy position (HELP) and a 25\u00b0 backup have been proposed to enhance glottic visualisation, yet concerns about ergonomic discomfort hinder their widespread adoption. This study compares the comfort and posture adopted by anaesthesiologists while performing laryngoscopy and tracheal intubation with patients in HELP while in a supine position or with 25\u00b0 backup.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n The study included 48 patients aged 18\u201360 years with normal airways and 12 experienced anaesthesiologists. Patients were randomised into two groups using permuted block randomisation. Anaesthesiologists performed laryngoscopy and intubation in supine HELP and 25\u00b0 backup HELP positions. Anaesthesiologist\u2019s posture was determined by measuring the angles of neck, wrist, elbow, back and knee joints, which were compared using Student\u2019s\n t<\/jats:italic>\n -test, and subjective comfort assessed on a Likert scale was compared using the Chi-square test. As mentioned by the anaesthesiologist, Cormack- Lehane grading was also noted and compared using a Chi-square test between groups, taking a\n P<\/jats:italic>\n value <0.05 as significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Both positions demonstrated comparable anaesthesiologist posture (\n P<\/jats:italic>\n = 0.919) and comfort (\n P<\/jats:italic>\n = 0.644). However, the 25\u00b0 backup HELP positions significantly improved Cormack\u2013Lehane grades, with 68% achieving grade 1 compared to 31% in the supine HELP group (\n P<\/jats:italic>\n = 0.012). Haemodynamic stability and tracheal intubation time showed no significant differences between the groups (\n P<\/jats:italic>\n = 0.475 and 0.117, respectively), and no complications were reported in either group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Anaesthesiologists\u2019 posture and comfort during laryngoscopy and tracheal intubation are similar between supine and 25\u00b0 backup in patients with easy airways.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_1130_23","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T07:00:39Z","timestamp":1715065239000},"page":"547-552","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Comparing the posture and comfort of anaesthesiologists during laryngoscopy and tracheal intubation in the head-elevated laryngoscopy position in supine position and with a 25\u00b0 backup: A randomised clinical crossover trial"],"prefix":"10.4103","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8009-9642","authenticated-orcid":false,"given":"R","family":"Mookambika","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Surgical Intensive Care Unit, MGM Healthcare, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1229-7975","authenticated-orcid":false,"given":"RV","family":"Hemanth Kumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth Deemed to be University, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3288-1677","authenticated-orcid":false,"given":"Archana","family":"Areti","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5007-3158","authenticated-orcid":false,"given":"V","family":"Jaya","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, JIPMER, Karaikal, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,5,8]]},"reference":[{"key":"R1-20260504","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/s12871-016-0280-4","article-title":"Comparison of glottic views and intubation times in the supine and 25-degree back-up positions","volume":"16","author":"Reddy","year":"2016","journal-title":"BMC Anesthesiol"},{"key":"R2-20260504","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jclinane.2014.09.012","article-title":"Head elevation improves laryngeal exposure with direct laryngoscopy","volume":"27","author":"El-Orbany","year":"2015","journal-title":"J Clin Anesth"},{"key":"R3-20260504","doi-asserted-by":"crossref","first-page":"344","DOI":"10.4103\/ija.IJA_672_17","article-title":"A randomised comparative study on customised versus fixed-sized pillows for tracheal intubation in the sniffing position by Macintosh laryngoscopy","volume":"62","author":"Dhar","year":"2018","journal-title":"Indian J Anaesth"},{"key":"R4-20260504","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1093\/bja\/aet428","article-title":"Higher operating tables provide better laryngeal views for tracheal intubation","volume":"112","author":"Lee","year":"2014","journal-title":"Br J Anaesth"},{"key":"R5-20260504","first-page":"772","article-title":"Posture used by anaesthetists during laryngoscopy","volume":"89","author":"Walker","year":"2002","journal-title":"Br J Anaesth"},{"key":"R6-20260504","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1111\/anae.15530","article-title":"Ergonomics in the anaesthetic workplace: Guideline from the Association of Anaesthetists","volume":"76","author":"Bailey","year":"2021","journal-title":"Anaesthesia"},{"key":"R7-20260504","doi-asserted-by":"crossref","first-page":"306","DOI":"10.4103\/0019-5049.181590","article-title":"Ergonomical aspects of anaesthetic practice","volume":"60","author":"Raghavendra Rao","year":"2016","journal-title":"Indian J Anaesth"},{"key":"R8-20260504","doi-asserted-by":"crossref","first-page":"289","DOI":"10.4103\/joacp.JOACP_254_19","article-title":"Optimal position for laryngoscopy \u2013 Time for individualization?","volume":"35","author":"Myatra","year":"2019","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"R9-20260504","doi-asserted-by":"crossref","first-page":"19","DOI":"10.4103\/2665-9425.325145","article-title":"Patient positioning and glottic visualisation: A narrative review","volume":"3","author":"Kumar","year":"2020","journal-title":"Airway"},{"key":"R10-20260504","doi-asserted-by":"crossref","first-page":"453","DOI":"10.5152\/TJAR.2021.1058","article-title":"Comparison of the glottic views in a head elevated laryngoscopy position with the patient in supine or 25\u00b0 backup: An observer-blinded randomised clinical trial","volume":"49","author":"Nandhakumar","year":"2021","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"R11-20260504","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/s12871-022-01706-5","article-title":"Effects of head-elevated position on tracheal intubation using a McGrath MAC videolaryngoscope in patients with a simulated difficult airway: A prospective randomized crossover study","volume":"22","author":"Chun","year":"2022","journal-title":"BMC Anesthesiol"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_1130_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:43:08Z","timestamp":1786650188000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_1130_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,8]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_1130_23","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,8]]},"assertion":[{"value":"2023-11-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-08","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}