Sharma Ankur, Vyas Varuna, Goyal Shilpa, Bhatia Pradeep, Sethi Priyanka, Goel Akhil Dhanesh
All India Institute of Medical Sciences (AIIMS), Department of Trauma & Emergency (Anaesthesiology), Jodhpur, India.
All India Institute of Medical Sciences (AIIMS), Department of Pediatrics, Jodhpur, India.
Braz J Anesthesiol. 2023 Sep-Oct;73(5):620-625. doi: 10.1016/j.bjane.2021.01.011. Epub 2021 Mar 22.
Nasogastric tube insertion and confirmation of its position can be difficult in the anesthetized patient. The purpose of the present study was to compare the bubble technique with the conventional method for confirmation of nasogastric tube placement in these patients.
Two hundred sixty adult patients, aged between 20...70 years, posted for surgeries requiring general anesthesia, tracheal intubation, and a nasogastric tube were enrolled in this study. Patients were randomized into 2 groups: Group B (Bubble group) and Group C (Control group). In Group C, a conventional technique using a lubricated nasogastric tube was positioned through the nostril with head remained neutral. In Group B, 2% lidocaine jelly was added to the proximal end to form a single bubble. The correct placement of the nasogastric tube in the stomach was confirmed by fluoroscopy by an independent observer intraoperatively.
The duration of nasogastric tube insertion was 57.2..13.3seconds in Group B and 59.8..11.9seconds in Group C (p=0.111). The confirmation rate of the bubble technique was 76.8% (95% CI: 68.7...83.3), which was significantly better than the conventional method where the confirmation rate was 59.7% (95% CI 50.9...67.9), p<0.001. When compared to fluoroscopy, bubble technique was found to have a sensitivity of 92.3% (95% CI: 85.6...96.1) with specificity of 81.0% (95% CI: 60.0...92.3), positive predictive value of 96.0% (95% CI: 90.2...98.4), and a moderate negative predictive value of 68.0% (95% CI: 48.4...82.8).
The bubble technique of nasogastric tube insertion has a higher confirmation rate in comparison to the conventional technique.
Clinical Trial Registry of India (CTRI/2018/09/015864).
在麻醉患者中，鼻胃管插入及其位置的确认可能具有挑战性。本研究的目的是比较气泡技术与传统方法在这些患者中确认鼻胃管位置的效果。
本研究纳入了260例年龄在20至70岁之间、拟行全身麻醉、气管插管和鼻胃管置入手术的成年患者。患者被随机分为两组：B组（气泡组）和C组（对照组）。在C组中，采用传统技术，将润滑后的鼻胃管经鼻孔插入，头部保持中立位。在B组中，在鼻胃管近端添加2%利多卡因凝胶形成单个气泡。术中由独立观察者通过荧光透视确认鼻胃管在胃内的正确位置。
B组鼻胃管插入时间为57.2±13.3秒，C组为59.8±11.9秒（p = 0.111）。气泡技术的确认率为76.8%（95%CI：68.7至83.3），显著优于传统方法，传统方法的确认率为59.7%（95%CI：50.9至67.9），p<0.001。与荧光透视相比，气泡技术的灵敏度为92.3%（95%CI：85.6至96.1），特异度为81.0%（95%CI：60.0至92.3），阳性预测值为96.0%（95%CI：90.2至98.4），中度阴性预测值为68.0%（95%CI：48.4至82.8）。
与传统技术相比，鼻胃管插入的气泡技术具有更高的确认率。
印度临床试验注册中心（CTRI/2018/09/015864）。
