Comparison of Different Methods of Nasogastric Tube Insertion in Anesthetized and Intubated Patients

NCT02557204 | Completed

• 1 other identifier: AntalyaTRH 007
• Study Type: interventional
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

The primary aim of this study is to investigate the difference in the first attempt and overall success rate of different techniques for insertion of nasogastric tube. Secondary aim is to investigate the difference of the duration of insertion using the selected technique, complications during insertion such as kinking, knotting, mucosal bleeding

Conditions

Disorder of Abdomen

Keywords

nasogastric tube insertion; Video laryngoscope; success rate

Outcome Measures

Primary Outcomes (1)

• difference in the first attempt and overall success rate

  investigate the difference in the first attempt and overall success rate (with percentage) of different techniques for insertion of nasogastric tube.

  participants will be followed to the starting from the NG tube insert through the nostril until the confirm to successful insertion into stomach.

Secondary Outcomes (1)

• difference of the duration of insertion and complications during insertion

  participants will be followed for the duration of intraoperative period and postoperative 4 hours.

Study Arms (4)

conventional technique

ACTIVE COMPARATOR

the nasogastric tube will be inserted gently through a selected nostril with the head being maintained in the neutral position.

Procedure: conventional technique

head in the lateral position technique

EXPERIMENTAL

the patient's head will be turned to the right lateral position. Nasogastric tube will be inserted through the right nostril without any maneuvers of the neck.

Procedure: head in the lateral position technique

endotracheal tube assisted technique

EXPERIMENTAL

Nasogastric tube will be inserted the trimmed 7.5 mm internal diameter endotracheal tube what cut proximal end with sterile scissors and endotracheal tube will be advanced blindly into the oral cavity to a depth of approximately 18 cm without laryngoscope together the nasogastric tube.

Procedure: endotracheal tube assisted technique

videolaryngoscope technique

EXPERIMENTAL

Nasogastric tube was inserted transnasally and advanced into esophagus under direct vision.

Procedure: videolaryngoscope technique

Interventions

conventional technique PROCEDURE

the nasogastric tube will be inserted gently through a selected nostril with the head being maintained in the neutral position.

conventional technique

head in the lateral position technique PROCEDURE

the patient's head will be turned to the right lateral position. Nasogastric tube will be inserted through the right nostril without any maneuvers of the neck.

head in the lateral position technique

endotracheal tube assisted technique PROCEDURE

Nasogastric tube will be inserted the trimmed 7.5 mm internal diameter endotracheal tube what cut proximal end with sterile scissors and endotracheal tube will be advanced blindly into the oral cavity to a depth of approximately 18 cm without laryngoscope together the nasogastric tube.

endotracheal tube assisted technique

videolaryngoscope technique PROCEDURE

Nasogastric tube was inserted transnasally and advanced into esophagus under direct vision.

videolaryngoscope technique

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients who received general anaesthesia for elective abdominal surgeries that required nasogastric tube insertion.

You may not qualify if:

• Patients with a history of coagulopathy,
• nasal stenosis,
• upper respiratory tract diseases or anomalies,
• esophageal varix, esophageal hiatus hernia,
• base of skull fracture,
• loose teeth,
• Cormack and Lehane and/or Mallampati scores of 3 or 4,
• patients younger than 18 years and older than 70 years

Sponsors & Collaborators

• Antalya Training and Research Hospital: lead

Study Sites (1)

Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation

Antalya, 07100, Turkey (Türkiye)

Location

Related Publications (12)

• Kirtania J, Ghose T, Garai D, Ray S. Esophageal guidewire-assisted nasogastric tube insertion in anesthetized and intubated patients: a prospective randomized controlled study. Anesth Analg. 2012 Feb;114(2):343-8. doi: 10.1213/ANE.0b013e31823be0a4. Epub 2011 Nov 21.

  PMID: 22104075 BACKGROUND

• Moharari RS, Fallah AH, Khajavi MR, Khashayar P, Lakeh MM, Najafi A. The GlideScope facilitates nasogastric tube insertion: a randomized clinical trial. Anesth Analg. 2010 Jan 1;110(1):115-8. doi: 10.1213/ANE.0b013e3181be0e43. Epub 2009 Oct 27.

  PMID: 19861362 BACKGROUND

• Appukutty J, Shroff PP. Nasogastric tube insertion using different techniques in anesthetized patients: a prospective, randomized study. Anesth Analg. 2009 Sep;109(3):832-5. doi: 10.1213/ane.0b013e3181af5e1f.

  PMID: 19690254 BACKGROUND

• Kwon OS, Cho GC, Jo CH, Cho YS. Endotracheal tube-assisted orogastric tube insertion in intubated patients in an ED. Am J Emerg Med. 2015 Feb;33(2):177-80. doi: 10.1016/j.ajem.2014.11.004. Epub 2014 Nov 13.

  PMID: 25435406 BACKGROUND

• Chun DH, Kim NY, Shin YS, Kim SH. A randomized, clinical trial of frozen versus standard nasogastric tube placement. World J Surg. 2009 Sep;33(9):1789-92. doi: 10.1007/s00268-009-0144-x.

  PMID: 19626360 BACKGROUND

• Bong CL, Macachor JD, Hwang NC. Insertion of the nasogastric tube made easy. Anesthesiology. 2004 Jul;101(1):266. doi: 10.1097/00000542-200407000-00058. No abstract available.

  PMID: 15220819 BACKGROUND

• Ghatak T, Samanta S, Baronia AK. A new technique to insert nasogastric tube in an unconscious intubated patient. N Am J Med Sci. 2013 Jan;5(1):68-70. doi: 10.4103/1947-2714.106215.

  PMID: 23378961 BACKGROUND

• Tsai YF, Luo CF, Illias A, Lin CC, Yu HP. Nasogastric tube insertion in anesthetized and intubated patients: a new and reliable method. BMC Gastroenterol. 2012 Aug 1;12:99. doi: 10.1186/1471-230X-12-99.

  PMID: 22853453 BACKGROUND

• Okabe T, Goto G, Hori Y, Sakamoto A. Gastric tube insertion under direct vision using the King Vision video laryngoscope: a randomized, prospective, clinical trial. BMC Anesthesiol. 2014 Sep 25;14:82. doi: 10.1186/1471-2253-14-82. eCollection 2014.

  PMID: 25278810 BACKGROUND

• Illias AM, Hui YL, Lin CC, Chang CJ, Yu HP. A comparison of nasogastric tube insertion techniques without using other instruments in anesthetized and intubated patients. Ann Saudi Med. 2013 Sep-Oct;33(5):476-81. doi: 10.5144/0256-4947.2013.476.

  PMID: 24188942 BACKGROUND

• Milsom SA, Sweeting JA, Sheahan H, Haemmerle E, Windsor JA. Naso-enteric Tube Placement: A Review of Methods to Confirm Tip Location, Global Applicability and Requirements. World J Surg. 2015 Sep;39(9):2243-52. doi: 10.1007/s00268-015-3077-6.

  PMID: 25900711 BACKGROUND

• Halloran O, Grecu B, Sinha A. Methods and complications of nasoenteral intubation. JPEN J Parenter Enteral Nutr. 2011 Jan;35(1):61-6. doi: 10.1177/0148607110370976. Epub 2010 Oct 26.

  PMID: 20978245 BACKGROUND

Study Officials

• Ali S Kavakli, MD

  Antalya Training and Research Hospital

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 17, 2015
• First Posted: September 23, 2015
• Study Start: September 1, 2015
• Primary Completion: November 1, 2015
• Study Completion: November 1, 2015
• Last Updated: December 8, 2015

Record last verified: 2015-12

Locations

TU (1)