Comparison of four techniques of nasogastric tube insertion in anaesthetised, intubated patients: A randomized controlled trial

Abstract

Background and Aims:Insertion of nasogastric tubes (NGTs) in anaesthetised, intubated patients with a conventional method is sometimes difficult. Different techniques of NGT insertion have been tried with varying degree of success. The aim of this prospective, randomised, open-label study was to evaluate three modified techniques of NGT insertion comparing with the conventional method in respect of success rate, time taken for insertion and the adverse events.Methods:In the operation theatre of general surgery, the patients were randomly allocated into four groups: Group C (control group, n = 54), Group W (ureteral guide wire group, n = 54), Group F (neck flexion with lateral pressure, n = 54) and Group R (reverse Sellick's manoeuvre, n = 54). The number of attempts for successful NGT insertion, time taken for insertion and adverse events were noted.Results:All the three modified techniques were found more successful than the conventional method on the first attempt. The least time taken for insertion was noted in the reverse Sellick's method. However, on intergroup analysis, neck flexion and reverse Sellick's methods were comparable but significantly faster than the other two methods with respect to time taken for insertion.Conclusion:Reverse Sellick's manoeuver, neck flexion with lateral neck pressure and guide wire-assisted techniques are all better alternatives to the conventional method for successful, quick and reliable NGT insertion with permissible adverse events in anaesthetised, intubated adult patients. Further studies after eliminating major limitations of the present study are warranted to establish the superiority of any one of these modified techniques.

Digital assistance of nasogastric tube insertion in intubated patients under general anesthesia: A single-blinded prospective randomized study

“…[379] These complications were found to be significantly lower in D Group than in C Group. This is obviously related to the previously described higher success rate and lower number of attempts in Group D.…”

A randomized clinical trial of nasogastric tube insertion in intubated patient: comparison between finger method and reverse Sellick maneuver

“…Coiling or kinking of the NGT would result in nasopharyngeal or oropharyngeal lining trauma, characterized by the presence of blood spots. 5,6 However, there are several limitations in this study. There was no subject classification based on prediction difficulty of NGT insertion preoperatively, i.e., opening oral cavity, the distance between mentohyoid and thyrohyoid, and others.…”

Comparison of the GlideScopeTM Visualization and Neck Flexion with Lateral Neck Pressure Nasogastric Tube Insertion techniques in Anaesthetized Patients: A Prospective Randomized Clinical Study

“…The conventional method for NGT insertion is blinded technique with the patient's head in a neutral position, whereby success rates have been reported to vary from 40-58% [9][10][11]. Various techniques have been proposed to facilitate NGT insertion with variable success rate [4][5][6][7][8][9][10][11][12][13][14][15]. Study by Appukutty and Shroff [9] reported that flex neck with lateral neck pressure was the easy method with high success rate.…”