A comparison of nasogastric tube insertion techniques without using other instruments in anesthetized and intubated patients

BACKGROUND AND OBJECTIVES: Several techniques are available to facilitate nasogastric (NG) tube insertion with or without using other instruments to guide the NG tube to the stomach. This study aimed to determine the success rate and time required for inserting NG tube by 2 non-instrumental methods of NG tube insertion and compare the findings with the common method of NG tube insertion. DESIGN AND SETTINGS: A prospective randomized, controlled clinical trial carried out at Chang Gung Memorial Hospital in Taiwan. SUBJECTS AND METHODS: A total of 150 patients were randomized into 3 groups: control group, neck flexion with lateral pressure group, and lifting of the larynx group. The number of attempted insertions, success rate, duration of insertion, and various complications were recorded. RESULTS: Both neck flexion with lateral pressure and lifting of the thyroid cartilage techniques had high success rates; however, the time required to insert the NG tube was shortest in the thyroid cartilage lifting group. CONCLUSION: Neck flexion with lateral pressure and lifting of the thyroid cartilage are convenient and reliable techniques for NG tube insertion without using any other instruments. Lifting of the thyroid cartilage had the highest success rate and was less time consuming than the other NG tube insertion techniques. Familiarization with the procedure influenced the success rate and the time required for insertion.