Comparison of Three Techniques of Nasogastric Tube Insertion Without Instrumentation

Comparison of Three Techniques of Nasogastric Tube Insertion Without Instrumentation in Anesthetised Intubated Patients: A Prospective Randomized Controlled Trial

This study compares two modified techniques(contralateral cricothyroid pressure and ipsilateral head turning technique) of nasogastric tube insertion in anesthetized and intubated patients with the conventional technique.

Study Overview

• Status: Completed
• Conditions: General Anesthesia
• Intervention / Treatment: Other: Conventional technique; Other: Contralateral cricothyroid pressure; Other: Ipsilateral head turning

Detailed Description

The insertion of nasogastric tube in anesthetized, paralysed and intubated unconscious patients may be difficult, with a reported failure rate of nearly 50% on the first attempt, with the head in neutral position there are many different maneuvers to facilitate the insertion of nasogastric tube published.

Our hypothesis is that contralateral cricothyroid pressure to the selected nostril for nasogastric tube insertion will be able to avoid the difficulty.

Therefore we are going to compare this technique with the conventional technique (head in neutral position) with lateral head turning group and contralateral cricothyroid pressure group We hope that the contralateral cricothyroid pressure will increase the success rate, as this will be helpful in intubated patients with neck pathology.

• Study Type: Interventional
• Enrollment (Actual): 27
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• patient who is scheduled for elective surgery under general anaesthesia requiring NGT insertion
• aged 20 to 70 years old
• with normal airway (Commack Lehane 1 or 2) and neck movements.

Exclusion Criteria:

• Patient who has nasal stenosis, nasal septal deviation, upper airway deformity, base of skull fracture, oesophageal disorders, coagulopathy, and pregnant.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Conventional technique; Nasogastric tube	Other: Conventional technique; Nasogastric tube insertion with patient's head in neutral position
Experimental: Contralateral cricothyroid pressure; Nasogastric tube	Other: Contralateral cricothyroid pressure; Cricothyroid pressure is applied externally in the contralateral direction of selected nostril before nasogastric insertion.
Experimental: Ipsilateral head turning; Nasogastric tube	Other: Ipsilateral head turning; Patient's head is turned to the ipsilateral side of the selected nostril before nasogastric tube insertion.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall success rate	Percentage	At induction of general anesthesia

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
First attempt success rate	Percentage	At induction of general anesthesia
Time taken to successful nasogastric tube placement	Procedure start time is defined as the time when the nasogastric tube is inserted through the nostril. The procedure end time is defined as the time of successful insertion and confirmed NGT placement or the time after two failed attempts. The outcome is measured in second.	At induction of general anesthesia

Collaborators and Investigators

• Sponsor: University of Malaya
• Investigators: Principal Investigator: Sook Hui Chaw, M.Med, University of Malaya

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2016
• Primary Completion (Actual): December 31, 2016
• Study Completion (Actual): December 31, 2016

Study Registration Dates

• First Submitted: April 2, 2018
• First Submitted That Met QC Criteria: April 6, 2018
• First Posted (Actual): April 9, 2018

Study Record Updates

• Last Update Posted (Actual): April 9, 2018
• Last Update Submitted That Met QC Criteria: April 6, 2018
• Last Verified: April 1, 2018

More Information

Terms related to this study

• Keywords: general anesthesia; nasogastric tube; head position
• Other Study ID Numbers: 201510-1718

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No