نبذة مختصرة : Purpose: We studied whether a newly available gastric tube insertion guide (Fuji Medical, Tokyo, Japan) was effective in insertion of a nasogastric tube.
Methods: Sixty anesthetized patients were randomly allocated to three groups, and we attempted to insert a nasogastric tube with a blind technique (Group B), with the lateral neck pressure (Group L), or with the tube guide (Group G). If the insertion failed in Group B or L, its insertion was attempted with the tube guide. Primary outcome measure was the insertion success rate within 300 s.
Results: The success rate in Group G (19 of 20 patients) was significantly higher than Group L (13 of 20 patients) (P = 0.04; 95% confidence intervals for difference: 16-44%), and than Group B (11 of 19 patients) (P = 0.008; 23-50%). In the 15 patients of Groups B and L, in whom insertion had failed, insertion with the tube guide was successful in 14 patients. There was no significant difference in insertion time between the groups, but in patients in whom insertion was successful, it was significantly longer in Group G (median of 147 s) than in Group L (66 s) (P < 0.01) and Group B (46 s) (P < 0.01). Minor complications occurred in 2 patients in Group B, 1 in Group L, and 5 in Group G (P > 0.05).
Conclusion: We conclude that the gastric tube insertion guide (Fuji Medical, Tokyo, Japan) may be useful when the conventional method of insertion has failed.
(© 2022. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.)
References: Sanaie S, Mahmoodpoor A, Najafi M. Nasogastric tube insertion in anesthetized patients: a comprehensive review. Anaesthesiol Intensive Therapy. 2017;49:57–65. (PMID: 10.5603/AIT.a2017.0001)
Appukutty J, Shroff PP. Nasogastric tube insertion using different techniques in anesthetized patients: a prospective, randomized study. Anesth Analg. 2009;109:832–5. (PMID: 10.1213/ane.0b013e3181af5e1f19690254)
Kavakli AS, Ozturk NK, Karaveli A, Onuk AA, Ozyurek L, Inanoglu K. Comparison of different methods of nasogastric tube insertion in anesthetized and intubated patients. Rev Bras Anestesiol. 2017;67:578–83. (PMID: 10.1016/j.bjan.2017.04.02028546013)
Alflen C, Kriege M, Schmidtmann I, Noppens RR, Piepho T. Orogastric tube insertion using the new gastric tube guide: first experiences from a manikin study. BMC Anesthesiol. 2017;17:54. (PMID: 10.1186/s12871-017-0343-1283767455379493)
Kriege M, Heid F, Alflen C, Schmidtmann I, Dette F, Noppens R, Piepho T. The orogastric tube guide ® as a novel strategy for gastric tube insertion: a prospective, randomized controlled clinical trial. Minerva Anestesiol. 2020;86:416–22. (PMID: 10.23736/S0375-9393.19.14076-X31818089)
Bong CL, Macachor JD, Hwang NC. Insertion of the nasogastric tube made easy. Anesthesiology. 2004;101:266. (PMID: 10.1097/00000542-200407000-0005815220819)
Tang J, Merritt RE, Essandoh M. Entrapment of an EZ-Blocker in the Murphy eye of an endotracheal tube. J Cardiothorac Vasc Anesth. 2019;33:2873–4. (PMID: 10.1053/j.jvca.2019.04.00631078375)
Arora R, Kumar S, Sachan S. Guide wire migrating into Murphy’s eye of endotracheal tube: an unusual complication of percutaneous dilatational tracheostomy. Anesth Essays Res. 2017;1:1091–3. (PMID: 10.4103/aer.AER_45_17)
Psarras K, Lalountas MA, Symeonidis NG, Baltatzis M, Pavlidis ET, Ballas K, Pavlidis TE, Sakantamis AK. Inadvertent insertion of a nasogastric tube into the brain: case report and review of the literature. Clin Imaging. 2012;36:587–90. (PMID: 10.1016/j.clinimag.2011.12.02022920367)
Motta APG, Rigobello MCG, Silveira RCCP, Gimenes FRE. Nasogastric/nasoenteric tube-related adverse events: an integrative review. Rev Lat Am Enfermagem. 2021;29:3400. (PMID: 10.1590/1518-8345.3355.3400)
Fan EMP, Tan SB, Ang SY. Nasogastric tube placement confirmation: where we are and where we should be heading. Proc Singapore Healthcare. 2017;26:189–95. (PMID: 10.1177/2010105817705141)
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