Comparison of different methods of nasogastric tube insertion in anesthetized and intubated patients

• Published in: Brazilian journal of anesthesiology (Elsevier) 2017-11, Vol.67 (6), p.578-583
• Main Authors: Kavakli, Ali Sait, Kavrut Ozturk, Nilgun, Karaveli, Arzu, Onuk, Asuman Arslan, Ozyurek, Lutfi, Inanoglu, Kerem
• Format: Article
• Language: eng ; por
• Subjects: Anesthesia; ANESTHESIOLOGY; Endotracheal tube assisted; Female; Humans; Intubation, Gastrointestinal - adverse effects; Intubation, Gastrointestinal - methods; Intubation, Intratracheal; Intubation, nasogastric; Intubação traqueal assistida; Intubação, nasogástrica; Laryngoscopy; Male; Middle Aged; Success rate; Taxa de sucesso; Video laryngoscope; Videolaringoscópio
• ISSN: 0104-0014; 1806-907X; 0104-0014; 1806-907X
• DOI: 10.1016/j.bjane.2016.08.002

Nasogastric tube insertion may be difficult in anesthetized and intubated patients with head in the neutral position. Several techniques are available for the successful insertion of nasogastric tube. The primary aim of this study was to investigate the difference in the first attempt success rate of different techniques for insertion of nasogastric tube. Secondary aim was to investigate the difference of the duration of insertion using the selected technique, complications during insertion such as kinking and mucosal bleeding. 200 adult patients, who received general anesthesia for elective abdominal surgeries that required nasogastric tube insertion, were randomized into four groups: Conventional group (Group C), head in the lateral position group (Group L), endotracheal tube assisted group (Group ET) and McGrath video laryngoscope group (Group MG). Success rates, duration of insertion and complications were noted. Success rates of nasogastric tube insertion in first attempt and overall were lower in Group C than Group ET and Group MG. Mean duration and total time for successful insertion of NG tube in first attempt were significantly longer in Group ET. Kinking was higher in Group C. Mucosal bleeding was statistically lower in Group MG. Use of video laryngoscope and endotracheal tube assistance during NG tube insertion compared with conventional technique increase the success rate and reduce the kinking in anesthetized and intubated adult patients. Use of video laryngoscope during nasogastric tube insertion compared to other techniques reduces the mucosal bleeding in anesthetized and intubated adult patients. A inserção de sonda nasogástrica (NG) pode ser difícil em pacientes anestesiados e intubados com a cabeça em posição neutra. Há várias técnicas para a inserção bem-sucedida de sonda NG. O objetivo primário deste estudo foi investigar a diferença da taxa de sucesso na primeira tentativa de diferentes técnicas para inserção de sonda NG. O objetivo secundário foi investigar a diferença do tempo de inserção com o uso da técnica selecionada e as complicações durante a inserção (dobradura da sonda e sangramento da mucosa). 200 pacientes adultos que receberam anestesia geral para cirurgias abdominais eletivas que exigiam inserção de sonda NG foram randomicamente distribuídos em quatro grupos: grupo convencional (Grupo C), grupo com a cabeça posicionada lateralmente (Grupo L), grupo com assistência de tubo traqueal (Grupo TE) e grupo com videolaringoscópio