Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver alone

Background: Nasogastric tube (NGT) insertion is an essential procedure in the operating room for which the anesthesiologists often take the responsibility. This simple procedure often becomes difficult in anesthetized patients. Literature reveals the flooding of studies and novel techniques are in t...

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Main Authors: Mrinal Kanti Roy, Sanjay Maitra, Sangita Mandal, Arpita Laha, Mohanchandra Mandal
Format: Article
Language:English
Published: Manipal College of Medical Sciences, Pokhara 2023-02-01
Series:Asian Journal of Medical Sciences
Subjects:
Online Access:https://www.nepjol.info/index.php/AJMS/article/view/49599
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author Mrinal Kanti Roy
Sanjay Maitra
Sangita Mandal
Arpita Laha
Mohanchandra Mandal
author_facet Mrinal Kanti Roy
Sanjay Maitra
Sangita Mandal
Arpita Laha
Mohanchandra Mandal
author_sort Mrinal Kanti Roy
collection DOAJ
description Background: Nasogastric tube (NGT) insertion is an essential procedure in the operating room for which the anesthesiologists often take the responsibility. This simple procedure often becomes difficult in anesthetized patients. Literature reveals the flooding of studies and novel techniques are in the pipeline, indicating that quest for the best is still on. Aims and Objectives: The aim of the study was to determine the proportion of patients in whom successful NGT insertion would be possible in the first attempt using either the “Reverse Sellick’s maneuver (RSM) with throat pack in situ” technique or RSM alone; and to compare the proportions between the two groups. Materials and Methods: This interventional study was performed on 222 adult patients (≥18 years), undergoing abdominal surgeries requiring intraoperative NGT insertion. Patients received NGT insertion using the combined RSM with “throat pack in situ” technique (Group A, n=111) or RSM alone (Group B, n=111). The proportion of patients in whom successful NGT insertion was possible in the first attempt using either of the techniques and the time taken for correct placement of NGT in both the groups. In addition, the incidence of adverse events was noted. Results: Although, NGT placement was possible in higher proportions of patients in Group A in first attempt compared with Group B (91% vs. 83.8%), it was not significant on analysis (P=0.106). The procedure time in both the groups was comparable (30.0±4.0 vs. 29.9±4.3, P=0.859). Coiling was found to be significantly more in the RSM alone technique as compared to the combined method. (P=0.04). Conclusion: With comparable success rate and lesser incidence of adverse events, it can be commented that the RSM with throat pack in situ technique appears to be a better alternative to RSM alone.
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spelling doaj.art-b27344e754b1479585c8e2cbb1abd3d62023-02-01T23:44:21ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762023-02-011423945https://doi.org/10.3126/ajms.v14i2.49599Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver aloneMrinal Kanti Roy 0https://orcid.org/0000-0002-5644-7528Sanjay Maitra 1https://orcid.org/0000-0002-5446-480XSangita Mandal 2https://orcid.org/0000-0002-3416-9344Arpita Laha 3https://orcid.org/0000-0003-0950-8188Mohanchandra Mandal 4https://orcid.org/0000-0003-4183-993XPost Graduate Trainee, Department of Anaesthesiology, Institute of Post Graduate Medical Education and Research/Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India Associate Professor, Department of Surgery, N.R.S. Medical College and Hospital, Kolkata, West Bengal, India Assistant Professor, Department of Anaesthesiology, Institute of Post Graduate Medical Education and Research/Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India Professor and Head, Department of Anaesthesiology, Institute of Post Graduate Medical Education and Research/Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India Professor, Department of Anaesthesiology, Institute of Post Graduate Medical Education and Research/Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India Background: Nasogastric tube (NGT) insertion is an essential procedure in the operating room for which the anesthesiologists often take the responsibility. This simple procedure often becomes difficult in anesthetized patients. Literature reveals the flooding of studies and novel techniques are in the pipeline, indicating that quest for the best is still on. Aims and Objectives: The aim of the study was to determine the proportion of patients in whom successful NGT insertion would be possible in the first attempt using either the “Reverse Sellick’s maneuver (RSM) with throat pack in situ” technique or RSM alone; and to compare the proportions between the two groups. Materials and Methods: This interventional study was performed on 222 adult patients (≥18 years), undergoing abdominal surgeries requiring intraoperative NGT insertion. Patients received NGT insertion using the combined RSM with “throat pack in situ” technique (Group A, n=111) or RSM alone (Group B, n=111). The proportion of patients in whom successful NGT insertion was possible in the first attempt using either of the techniques and the time taken for correct placement of NGT in both the groups. In addition, the incidence of adverse events was noted. Results: Although, NGT placement was possible in higher proportions of patients in Group A in first attempt compared with Group B (91% vs. 83.8%), it was not significant on analysis (P=0.106). The procedure time in both the groups was comparable (30.0±4.0 vs. 29.9±4.3, P=0.859). Coiling was found to be significantly more in the RSM alone technique as compared to the combined method. (P=0.04). Conclusion: With comparable success rate and lesser incidence of adverse events, it can be commented that the RSM with throat pack in situ technique appears to be a better alternative to RSM alone.https://www.nepjol.info/index.php/AJMS/article/view/49599anesthetized; intubation; nasogastric tube; reverse sellick’s maneuver; throat pack
spellingShingle Mrinal Kanti Roy
Sanjay Maitra
Sangita Mandal
Arpita Laha
Mohanchandra Mandal
Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver alone
Asian Journal of Medical Sciences
anesthetized; intubation; nasogastric tube; reverse sellick’s maneuver; throat pack
title Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver alone
title_full Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver alone
title_fullStr Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver alone
title_full_unstemmed Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver alone
title_short Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver alone
title_sort nasogastric tube insertion in anesthetized intubated adult patients a comparison between the reverse sellick s maneuver with throat pack in situ and reverse sellick s maneuver alone
topic anesthetized; intubation; nasogastric tube; reverse sellick’s maneuver; throat pack
url https://www.nepjol.info/index.php/AJMS/article/view/49599
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