Kavakli Ali Sait, Kavrut Ozturk Nilgun, Karaveli Arzu, Onuk Asuman Arslan, Ozyurek Lutfi, Inanoglu Kerem
Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation, Antalya, Turkey.
Antalya Training and Research Hospital, Department of Anesthesiology and Reanimation, Antalya, Turkey.
Rev Bras Anestesiol. 2017 Nov-Dec;67(6):578-583. doi: 10.1016/j.bjan.2017.04.020. Epub 2017 May 22.
Nasogastric tube insertion may be difficult in anesthetized and intubated patients with head in the neutral position. Several techniques are available for the successful insertion of nasogastric tube. The primary aim of this study was to investigate the difference in the first attempt success rate of different techniques for insertion of nasogastric tube. Secondary aim was to investigate the difference of the duration of insertion using the selected technique, complications during insertion such as kinking and mucosal bleeding.
200 adult patients, who received general anesthesia for elective abdominal surgeries that required nasogastric tube insertion, were randomized into four groups: Conventional group (Group C), head in the lateral position group (Group L), endotracheal tube assisted group (Group ET) and McGrath video laryngoscope group (Group MG). Success rates, duration of insertion and complications were noted.
Success rates of nasogastric tube insertion in first attempt and overall were lower in Group C than Group ET and Group MG. Mean duration and total time for successful insertion of NG tube in first attempt were significantly longer in Group ET. Kinking was higher in Group C. Mucosal bleeding was statistically lower in Group MG.
Use of video laryngoscope and endotracheal tube assistance during NG tube insertion compared with conventional technique increase the success rate and reduce the kinking in anesthetized and intubated adult patients. Use of video laryngoscope during nasogastric tube insertion compared to other techniques reduces the mucosal bleeding in anesthetized and intubated adult patients.
对于头部处于中立位的麻醉和插管患者，插入鼻胃管可能会很困难。有几种技术可用于成功插入鼻胃管。本研究的主要目的是调查不同鼻胃管插入技术首次尝试成功率的差异。次要目的是调查使用所选技术插入的持续时间差异、插入过程中的并发症，如扭结和粘膜出血。
200名接受择期腹部手术全身麻醉且需要插入鼻胃管的成年患者，被随机分为四组：传统组（C组）、头部侧卧位组（L组）、气管内导管辅助组（ET组）和麦格拉斯视频喉镜组（MG组）。记录成功率、插入持续时间和并发症。
C组鼻胃管首次尝试插入成功率和总体成功率低于ET组和MG组。ET组首次成功插入鼻胃管的平均持续时间和总时间明显更长。C组扭结发生率更高。MG组粘膜出血在统计学上更低。
与传统技术相比，在鼻胃管插入过程中使用视频喉镜和气管内导管辅助可提高麻醉和插管成年患者的成功率并减少扭结。与其他技术相比，在鼻胃管插入过程中使用视频喉镜可减少麻醉和插管成年患者的粘膜出血。
