title: [Risk factors of nasogastric tube placement after elective colorectal surgery included in a rehabilitation programme: a multivariate analysis].
abstract: OBJECTIVE
  Nasogastric tube placement (NTP) is no more systematically recommended in patients scheduled for elective colorectal surgery but could be necessary in case of postoperative vomiting. The aim of this study was to determine independent risk factors for NTP after colorectal surgery.
  
  
  METHODS
  We performed an observational study including 290 patients scheduled for elective colorectal surgery included in an enhanced recovery programme: immunonutrition, thoracic epidural analgesia, antiemetic prophylaxis, respiratory physiotherapy, absence of NT and drainage, forced mobilization and oral nutrition. The main outcome was the occurrence of vomiting requiring NTP. Univariate analysis included: age, sex, BMI, American Society of Anesthesiologist Physical Status Classification System (ASA), duration of surgery, epidural analgesia, and mobilization, intraoperative fluid, temperature, laparotomy, use of droperidol, parenteral nutrition, stoma, diabetes, hypertension or coronary disease, COPD, type of surgery. A logistic regression was performed to determine independent risk factors of NTP.
  
  
  RESULTS
  Among the 290 patients included, 277 were analyzed. The incidence of NTP was 10.5% (95%CI [7.4-14.6%]). Univariate analysis documented BMI, low temperature in PACU (<35°C), ASA scores, duration of surgery and epidural analgesia, rectal and sigmoid resections, diabetes, transfusion, no use of droperidol, duration of mobilization, conversion to laparotomy. Three independent risk factors were associated with NTP: temperature in SSPI<35.5°C (OR: 14.49; IC95% [4.52-45.45], P<0.0001), BMI<21kg/m(2) (8.40; [1.99-35.71], P=0.0038) and lack of postoperative droperidol administration (3.37 [1.02-11.39], P=0.04).
  
  
  CONCLUSIONS
  After colorectal surgery tolerance to rapid oral feeding is impaired by denutrition and postoperative hypothermia. The combined used of postoperative droperidol should also be considered to avoid postoperative NTP.
authors.affiliation: Département d'anesthésie-réanimation chirurgicale, hôpital privé Sévigné, 3, rue du Chêne-Germain, 35510 Cesson-Sévigné, France. caveline@club-internet.fr
authors.forename: C
authors.initials: C
authors.lastname: Aveline
authors.forename: A
authors.initials: A
authors.lastname: Le Roux
authors.forename: H
authors.initials: H
authors.lastname: Le Hetet
authors.forename: P
authors.initials: P
authors.lastname: Vautier
authors.forename: F
authors.initials: F
authors.lastname: Cognet
authors.forename: F
authors.initials: F
authors.lastname: Bonnet
mesh_terms: D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use; D015992:Body Mass Index; D001831:Body Temperature; D003106:Colon / Q000601:surgery*; D003107:Colorectal Surgery / Q000379:methods*; D004329:Droperidol / Q000627:therapeutic use; D004434:Early Ambulation; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects* / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D018529:Nutritional Support; D011182:Postoperative Care; D012007:Rectum / Q000601:surgery*; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D000932:Antiemetics; D004329:Droperidol