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

Study Overview
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Brief Summary
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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

Detailed Description
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Two hundred adult patients, who received general anaesthesia for elective abdominal surgeries that required nasogastric tube insertion, will be randomized by means of a computer-generated randomization order into four groups: Conventional group (Group C), head in the lateral position group (Group L), endotracheal tube assisted group (group ET) and video laryngoscope group (group MG). Success rate of the selected technique (first attempt, second attempt and overall), duration of insertion for selected technique, complications such as kinking and mucosal bleeding will be noted.

Official Title
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Comparison of Different Methods of Nasogastric Tube Insertion in Anesthetized and Intubated Patients: A Prospective Randomized Controlled Trial

Conditions
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Disorder of Abdomen

Intervention / Treatment
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* Procedure: conventional technique
* Procedure: head in the lateral position technique
* Procedure: endotracheal tube assisted technique
* Procedure: videolaryngoscope technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who received general anaesthesia for elective abdominal surgeries that required nasogastric tube insertion. Exclusion Criteria: 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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: conventional technique<br>the nasogastric tube will be inserted gently through a selected nostril with the head being maintained in the neutral position. | Procedure: conventional technique<br>* the nasogastric tube will be inserted gently through a selected nostril with the head being maintained in the neutral position.<br>|
| Experimental: head in the lateral position technique<br>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<br>* 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.<br>|
| Experimental: endotracheal tube assisted technique<br>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<br>* 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.<br>|
| Experimental: videolaryngoscope technique<br>Nasogastric tube was inserted transnasally and advanced into esophagus under direct vision. | Procedure: videolaryngoscope technique<br>* Nasogastric tube was inserted transnasally and advanced into esophagus under direct vision.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| difference of the duration of insertion and complications during insertion | investigate the difference of the duration of insertion (in seconds) using the selected technique and complications (with number and percentage) during insertion such as kinking, knotting, mucosal bleeding | participants will be followed for the duration of intraoperative period and postoperative 4 hours. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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nasogastric tube insertion, Video laryngoscope, success rate