Nasogastric tube insertion using esophageal guide in anesthetized patients at University Hospital in Neiva

Abstract

The nasogastric tube insertion is a procedure that consists of introducing a polyvinyl probe through the nostrils, advancing it through the esophagus until it is located in the stomach. In patients under general anesthesia with orotracheal intubation, the insertion has a failure rate of up to 50% according to the technique in the first attempt. Situation that becomes a challenge even for experienced anesthesiologists. Objective. To evaluate the success rate and complications in the insertion of a nasogastric tube using an esophageal guide compared with blind digital technique. Materials and methods. Experimental study of a controlled clinical trial of two comparison groups, an experimental one of 19 patients (group A) in which the esophageal guide was used for the insertion of the nasogastric tube, and the other control of 21 patients (group B) with digital blind technique, in a period between the months of July and December 2012. Results: There were no significant differences between both groups (p> 0.5) in age, weight and height. The time used for probe insertion was significantly lower in group A with a mean in seconds of 70.89 seconds. The number of attempts in group A was much lower than in group B in 89.5% and 57.1% respectively for the 1st and 2nd attempts, while in the 2nd and 3rd attempts it was 10.5% and 42.9 %; the incidence of rolling in group A was significantly lower than in group B with 21.1% and 71.4% respectively. There were no complications in group A with the insertion of the probe compared to 3 cases in group B, without presenting severe complications in either of the two groups. Conclusions. The use of a guide for the passage of the nasogastric tube proved to be a practical and effective procedure that allows a procedure in less time when it is used in a patient under general anesthesia with orotracheal intubation. The number of attempts to pass nasogastric tube with guidance is much lower compared to the non-use of it.  In addition, the deformations, which were mostly curled, occurred mainly when no guide was used, and the complications presented, nasal bleeding that only occurred in group B. Therefore, and according to the statistical analysis, the use of an esophageal guide is recommended for the passage of nasogastric tubes in an intubated patient.