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

NCT ID: NCT02557204

Last Updated: 2015-12-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-09-30

Study Completion Date

2015-11-30

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.

Conditions

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Disorder of Abdomen

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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conventional technique

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

Group Type ACTIVE_COMPARATOR

conventional technique

Intervention Type PROCEDURE

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

head in the lateral position technique

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.

Group Type EXPERIMENTAL

head in the lateral position technique

Intervention Type 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.

endotracheal tube assisted technique

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.

Group Type EXPERIMENTAL

endotracheal tube assisted technique

Intervention Type 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.

videolaryngoscope technique

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

Group Type EXPERIMENTAL

videolaryngoscope technique

Intervention Type PROCEDURE

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

Interventions

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conventional technique

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

Intervention Type PROCEDURE

head in the lateral position technique

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.

Intervention Type PROCEDURE

endotracheal tube assisted technique

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.

Intervention Type PROCEDURE

videolaryngoscope technique

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

Intervention Type PROCEDURE

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
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Antalya Training and Research Hospital

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ali S Kavakli, MD

Role: STUDY_DIRECTOR

Antalya Training and Research Hospital

Locations

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Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation

Antalya, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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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.

Reference Type BACKGROUND
PMID: 22104075 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 19861362 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 19690254 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25435406 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 19626360 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 15220819 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 23378961 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 22853453 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25278810 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 24188942 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25900711 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 20978245 (View on PubMed)

Other Identifiers

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AntalyaTRH 007

Identifier Type: -

Identifier Source: org_study_id