Meta-Analysis
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7772-7785
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7772
Comparison of different methods of nasogastric tube insertion in anesthetized and intubated patients: A meta-analysis
Gao-Wen Ou, Heng Li, Bing Shao, Li-Ming Huang, Guo-Min Chen, Wei-Chao Li
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
Processing time: 194 Days and 5.2 Hours
ARTICLE HIGHLIGHTS
Research background

Several techniques of nasogastric tube (NGT) insertion have been described in the literature with different success rates. The best NGT insertion method is still unclear.

Research motivation

No meta-analysis has summarized the evidence with the intent to provide reliable information both in terms of relative advantages of the techniques and their associated complication rates.

Research objectives

To compare the success rates, insertion time, and complications associated with different techniques of NGT insertion in anesthetized and intubated patients.

Research methods

An electronic search of the PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar databases was performed up to October 31, 2019.

Research results

Seventeen randomized controlled trials (RCTs) featuring data on 2500 patients showed that successful insertion of the NGT on the first attempt was higher with modified techniques such as the reverse Sellick’s maneuver, use of a frozen NGT, adopting neck flexion and lateral neck pressure, as well as endotracheal tube-assisted and video-assisted placements. All modified techniques also led to comparatively higher overall insertion success rates.

Research conclusions

The use of modified techniques of NGT insertion appears superior to conventional methods. However, limited available data makes drawing a strong conclusion difficult.

Research perspectives

Further homogenous large-scale RCTs comparing multiple techniques of NGT insertion are needed to strengthen the evidence on this important subject.