Modified Gastric Biopsy Forceps as a Flexible StyletAssisted Nasogastric Tube Insertion in Anesthetized and Intubated Patients: A Prospective Randomized Controlled Study
นรุตม์ เรือนอนุกูล, อมร วิจิตรพาวรรณ*, ชุติมา สิมะสาธิตกุล
Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; Phone: +66-2-2011552, Fax: +66-2-2011569 ;Email:
Background: Insertion of a nasogastric tube in an anesthetized intubated patient may be difficult. A nasogastric tube is prone to coil and kink during insertion. The authors hypothesized that gastric biopsy forceps could be used as a flexible stylet-assisted nasogastric tube insertion. It can improve the first-attempt success rate over the conventional blind technique during nasogastric tube insertion in the anesthetized intubated patient.
Materials and Methods: Eighty adult patients who required intraoperative nasogastric tube insertions were randomized to the gastric biopsy forceps assisted technique (stylet group) or the conventional blind technique (control group) for insertion of a nasogastric tube. The success rates, the duration of insertion, the incidences of coiling and kinking of a nasogastric tube, and the occurrences of complications were recorded.
Results: The first-attempt success rate was 92.5% in the stylet group compared with 65% in the control group (p=0.013). The overall success rate was higher in the stylet group (100% versus 85%, p=0.026). The mean time required to insert the nasogastric tube was shorter in the stylet group (24.85±9.62 versus 62.4±59.38 seconds, p=0.002). The incidences of coiling and kinking were lower in the stylet group (7.5% versus 32.5%, p=0.005). The incidence of minor bleeding was lower in the stylet group, but not statistically significant (2.5% versus 17.5%, p=0.057). No other complications were observed in either groups.
Conclusion: The gastric biopsy forceps-assisted nasogastric tube insertion resulted in a higher success rate, less time for insertion, and lower incidence of coiling and kinking of a nasogastric tube than the conventional blind technique in anesthetized intubated patients without serious complications.
วารสารจดหมายเหตุทางการแพทย์ ปี 2564, August ปีที่: 104 ฉบับที่ 8 หน้า 1222-1228
success rate, Nasogastric tube, Insertion, Stylet, Gastric biopsy forceps