A painful and knotted nasogastric tube

Tapaiwala, Shruti Niranjan; Riyami, Dawood Al; Cole, Edward

doi:10.1503/cmaj.070750

Cited by 6 publications

(8 citation statements)

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“…Also, knotting of the NGT can occur as the tube can become coiled in the patient's stomach, which may lead to knotting when it is pulled out [49]. This has been shown to create extreme pain in the nasopharynx once the NGT is removed [49]. Other complications due to NGT misplacement include mucosal trauma [50,51], bronchial injury or perforation [51], and irritative rhinitis and pharyngitis [22,48].…”

Section: Pain and Discomfortmentioning

confidence: 99%

Does Nasogastric Tube Use During Cardiac Surgery Affect Postoperative Outcomes? A Narrative Review

Paleczny

Fatima

Amador-Gody

et al. 2022

Preprint

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Nasogastric tube (NGT) use has been common in the immediate postoperative period in surgical patients for decades. Potential advantages include the decompression of gastric contents and the early administration of time-sensitive medications. However, its routine use after cardiac surgery has not been established as a gold standard yet. The NGT use for prevention of post-operative nausea and vomiting has been a matter of debate in literature. Also, NGT use has also been associated with the incidence of some respiratory and gastrointestinal complications and it may be a source of significant pain and discomfort to patients. In this article, we review the current available literature regarding the use of NGT during and immediately after cardiac surgery, with particular emphasis on its potential role in enhanced postoperative recovery.

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Section: Pain and Discomfortmentioning

confidence: 99%

Does Nasogastric Tube Use During Cardiac Surgery Affect Postoperative Outcomes? A Narrative Review

Paleczny

Fatima

Amador-Gody

et al. 2022

Preprint

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“…49 This has been shown to create extreme pain in the nasopharynx once the NGT is removed. 49 Other complications due to NGT misplacement include mucosal trauma, 50,51 bronchial injury or perforation, 51 and irritative rhinitis and pharyngitis. 22,48 1.6 | Enhanced recovery after cardiac surgery Enhanced recovery after surgery (ERAS) is a multidisciplinary model that applies a bundle of evidence-based best practices to improve recovery rates for patients undergoing surgical procedures.…”

Section: Pain and Discomfortmentioning

confidence: 99%

Should nasogastric tube be used routinely in patients undergoing cardiac surgery? A narrative review

Paleczny

Fatima

Amador

et al. 2022

Journal of Cardiac Surgery

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Background and Aim: Nasogastric tube (NGT) use has been common in the immediate postoperative period in surgical patients for decades. Potential advantages include the decompression of gastric contents and the early administration of time‐sensitive medications. However, its routine use after cardiac surgery has not been established as a gold standard yet. The NGT use for prevention of postoperative nausea and vomiting has been a matter of debate in literature. Also, NGT use has also been associated with the incidence of some respiratory and gastrointestinal complications and it may be a source of significant pain and discomfort to patients. In this article, we review the current available literature regarding the use of NGT during and immediately after cardiac surgery, with particular emphasis on its potential role in enhanced postoperative recovery. Methods: We performed a database search in October 2021 using Embase, Cochrane Library, and Medline to identify studies that examined the use of NGT in patients that underwent cardiac surgery. Data and literature about NGT's impact on post‐operative nausea and vomiting, early administration of medications, interference with imaging, post‐operative complications, respiratory complications, gastrointestinal complications, pain and discomfort, and enhanced recovery after surgery were examined. Results: Three reports investigating the use of NGT to reduce post‐operative nausea and vomiting were examined with sample sizes of 114, 104, and 202. The use of NGT did not significantly reduce the incidence of post‐operative nausea and vomiting in 2/3 of the studies: a 2% nausea reduction with NGT (p < 0.05), a 7.7% nausea reduction with NGT (p = 0.6), and a 14% vomiting reduction with NGT (p = 0.007). The prevalence of pneumonia following NGT use has been shown to vary ranging from 4 to 95% with associated mortality rates of 17 to 62%. Conclusion: Based on our findings, there is currently not sufficient evidence to support the routine use of NGT during cardiac surgery. Further research is needed to establish the role of NGT in this patient population.

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“…Gastric tube knotting is a rare event that has been described in various case reports [1][2][3][4][5][6][7][8][9]. The purpose of the NGT is either for decompression of the stomach (to avoid aspiration on extubation and to relieve postoperative discomfort from distension) or postoperative enteral feeding.…”

Section: Introductionmentioning

confidence: 99%

“…The purpose of the NGT is either for decompression of the stomach (to avoid aspiration on extubation and to relieve postoperative discomfort from distension) or postoperative enteral feeding. Gastric tube knotting is a rare event that has been described in various case reports [1][2][3][4][5][6][7][8][9]. It can lead to pain, mucosal damage, entanglement with the tracheal tube and respiratory distress [2,3,[5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Accidental uvulectomy after removal of a nasogastric tube

et al. 2016

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The formation of a knot in a gastric tube is a rare event, but it can lead to complications. We describe a case in which an accidental uvulectomy occurred after retraction of a nasogastric feeding tube with an overhand knot in it. This knot probably formed in the pharynx of the patient and entangled the uvula on removal. This complication might have been avoided if the gastric tube was placed under direct vision or if it was removed more carefully. We recommend measuring the required tube length in order to prevent looping and knotting in the stomach.

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A painful and knotted nasogastric tube

Cited by 6 publications

References 0 publications

Does Nasogastric Tube Use During Cardiac Surgery Affect Postoperative Outcomes? A Narrative Review

Does Nasogastric Tube Use During Cardiac Surgery Affect Postoperative Outcomes? A Narrative Review

Should nasogastric tube be used routinely in patients undergoing cardiac surgery? A narrative review

Accidental uvulectomy after removal of a nasogastric tube

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