Conventional Blind Method Versus SORT Manoeuvre of Nasogastric Tube Insertion in Anaesthetised Patients: A Randomised Clinical Study
Introduction: Nasogastric Tube (NGT) placement is frequently performed in the preoperative period and critical care scenario. The SORT manoeuvre, a comparatively new method of NGT placement, is comprised of four components such as Sniffing position, Orientation of NGT, Rotation of patient’s head...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-10-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/15575/49732_CE[Ra1]_F[SH]_PF1(SC_SL)_PFA(KM_SHU)_PN(KM).pdf |
| Summary: | Introduction: Nasogastric Tube (NGT) placement is frequently
performed in the preoperative period and critical care scenario.
The SORT manoeuvre, a comparatively new method of NGT
placement, is comprised of four components such as Sniffing
position, Orientation of NGT, Rotation of patient’s head to
the contralateral side of the nostril being used, and Twisting
movements of hand. Any obstruction during introduction of NGT
is managed with withdrawal of NGT a bit, and proceeding again,
to find the path of least resistance, thereby reducing injury.
Aim: To determine the efficacy of SORT manoeuvre in comparison
with the conventional blind method of NGT insertion in anaesthetised
intubated adult patients.
Materials and Methods: The interventional, single-blinded,
parallel group, randomised study was conducted in Nil Ratan
Sircar Medical College and Hospital, a Government Medical
College, Kolkata, West Bengal, India. A total of 202 adult
patients, undergoing abdominal surgeries under general
anaesthesia, and requiring intraoperative NGT placement were
recruited for this study. The study spanned between February
2019 to April 2020. The patients were randomly allocated into
two groups to receive NGT placement using either conventional
blind technique (group B, n=101) or SORT manoeuvre (group S,
n=101). The proportion of patients in each group with successful
NGT placement in a single attempt was recorded. The procedure
time, haemodynamic parameters and the incidence of adverse
events were also noted. Chi-square test, Fisher’s-exact test,
Mann-Whitney test, and t-test were applied as appropriate
according to the nature of data.
Results: Successful NGT insertion in a single attempt was possible
in 95 patients (94%) using SORT maneuver in comparison with 78
patients (77.2%) using conventional blind method (p-value=0.0006).
The procedure time was longer using SORT method compared
with that using blind method (25 vs 22 seconds, respectively;
p-value=0.024). The incidence of all types of adverse events were
found to be considerably lower in patients receiving NGT placement
using SORT manoeuvre. In both the groups, coiling was found to be
the most common adverse event and that was also considerably
low with the SORT method compared with blind method (21.8% vs
43.6%, respectively; p-value=0.001).
Conclusion: The SORT manoeuvre appears to be a better
alternative to conventional technique for NGT insertion in
anaesthetised intubated adult patients, in terms of higher success
rate and lower adverse events. |
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| ISSN: | 2249-782X 0973-709X |