Ou GW, Li H, Shao B, Huang LM, Chen GM, Li WC. Comparison of different methods of nasogastric tube insertion in anesthetized and intubated patients: A meta-analysis. World J Clin Cases 2021; 9(26): 7772-7785 [PMID: 34621827 DOI: 10.12998/wjcc.v9.i26.7772]
Corresponding Author of This Article
Gao-Wen Ou, MD, Nurse, Department of Anesthesiology, Qingyuan People’s Hospital, The Six Affiliated Hospital of Guangzhou Medical University, No. B24 Yinquan North Road, Qingyuan 511518, Guangdong Province, China. wenzhemami@163.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Gao-Wen Ou, Heng Li, Bing Shao, Li-Ming Huang, Guo-Min Chen, Wei-Chao Li, Department of Anesthesiology, Qingyuan People’s Hospital, The Six Affiliated Hospital of Guangzhou Medical University, Qingyuan 511518, Guangdong Province, China
Author contributions: Ou GW contributed to the conception and design of the study, and drafting the article; Li H, Shao B, Huang LM, Chen GM, and Li WC contributed to the acquisition of data, analysis and interpretation of data; Ou GW contributed to revision of the article and final approval.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gao-Wen Ou, MD, Nurse, Department of Anesthesiology, Qingyuan People’s Hospital, The Six Affiliated Hospital of Guangzhou Medical University, No. B24 Yinquan North Road, Qingyuan 511518, Guangdong Province, China. wenzhemami@163.com
Received: February 28, 2021 Peer-review started: February 28, 2021 First decision: April 24, 2021 Revised: May 11, 2021 Accepted: July 2, 2021 Article in press: July 2, 2021 Published online: September 16, 2021
Abstract
BACKGROUND
Several techniques of nasogastric tube (NGT) insertion have been described in the literature with different success rates.
AIM
To systematically search the literature and conduct a meta-analysis comparing the success rates, insertion time and complications associated with different techniques of NGT insertion in anesthetized and intubated patients.
METHODS
An electronic search of the PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar databases were performed up to October 31, 2019. We included 17 randomized controlled trials with 2500 participants in the meta-analysis.
RESULTS
As compared to the conventional method, successful insertion of the NGT on first attempt was higher with modified techniques such as the reverse Sellick’s maneuver [relative risk (RR) 1.94; 95% confidence interval (CI): 1.62-2.31], use of a frozen NGT (RR 1.55; 95%CI: 1.13-2.13), inserting the NGT with neck flexion and lateral neck pressure (RR 1.64; 95%CI: 1.10-2.45), endotracheal tube-assisted (RR 1.88; 95%CI: 1.52-2.32) and video-assisted placements (RR 1.60; 95%CI: 1.31-1.95). All the modified techniques also led to comparatively higher insertion success rates than the conventional technique.
CONCLUSION
The use of modified techniques of NGT insertion such as the reverse Sellick’s maneuver, neck flexion with lateral neck pressure, frozen NGT, endotracheal tube-guided or video-assisted methods result in a significantly better chance of successful tube insertion at first attempt as compared to the conventional technique. All modified techniques also significantly improve the overall chance of successful NGT placement as compared to the conventional method.
Core Tip: Our study indicates that the use of modified techniques of nasogastric tube (NGT) insertion such as the reverse Sellick’s maneuver, neck flexion with lateral neck pressure, frozen NGT, endotracheal tube-guided or video-assisted methods result in a significantly better chance of successful tube insertion at first attempt as compared to the conventional technique.
