title: Gastric tube insertion under direct vision using the King Vision™ video laryngoscope: a randomized, prospective, clinical trial.
abstract: BACKGROUND
  The frequency of malpositioning of gastric tubes in the trachea has been reported to be 0.3-15%, which may cause severe complications, such as pneumonia, if not detected promptly. If a gastric tube can be guided into the esophagus under direct vision with a video laryngoscope, misplacement of the gastric tube into the trachea can be avoided. We compared gastric tube insertion under direct vision using a video laryngoscope with the conventional method of blind insertion.
  
  
  METHODS
  We enrolled 60 patients who required a transnasal gastric tube to facilitate elective abdominal surgery under general anesthesia. The participants were recruited consecutively into one of two groups, a group of 30 patients in whom a gastric tube was inserted using a King Vision™ video laryngoscope (KV group), and a group of 30 patients who underwent conventional blind insertion of the gastric tube (Blind group). The success rate, the time taken to insert the gastric tube, and the incidence of complications were compared.
  
  
  RESULTS
  In the KV group, the time required for gastric tube placement was 52.5 ± 17.1 seconds, with a success rate of 100%. Slight oral hemorrhage occurred in two participants and slight epistaxis in one participant. In the Blind group, the time required for gastric tube placement was 65.9 ± 39.9 seconds, with a success rate of 90% (27 out of 30 patients). Slight oral hemorrhage occurred in two participants, slight epistaxis occurred in two participants, and tracheal malposition occurred in one participant but was detected promptly and corrected using the video laryngoscope. There were no significant differences in the time required for placing the gastric tube, the success rate, or the incidence of complications between the groups.
  
  
  CONCLUSIONS
  Gastric tube insertion using a King Vision video laryngoscope was straightforward, and was particularly useful for detecting and correcting tracheal malpositioning.
  
  
  BACKGROUND
  
  UMIN000011014.
authors.affiliation: Department of Anesthesiology, Hitachi, Ltd. Hitachinaka General Hospital, 20-1 Ishikawa-cho, Hitachinaka-shi, Ibaraki 312-0057, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Okabe
authors.affiliation: Department of Anesthesiology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Gentaro
authors.initials: G
authors.lastname: Goto
authors.affiliation: Department of Anesthesiology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hori
authors.affiliation: Department of Anesthesiology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8603, Japan.
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Sakamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Gastric tube; King Vision; Tracheal malposition; Video laryngoscope