title: Nasogastric tube insertion using airway tube exchanger in anesthetized and intubated patients.
abstract: BACKGROUND
  A nasogastric tube (NGT) is commonly inserted into patients undergoing abdominal surgery to decompress the stomach during or after surgery. However, for anatomic reasons, the insertion of NGTs into anesthetized and intubated patients may be challenging. We hypothesized that the use of a tube exchanger for NGT insertion could increase the success rate and reduce complications.
  
  
  METHODS
  One hundred adult patients, aged 20-70 years, who were scheduled for gastrointestinal surgeries with general anesthesia and NGT insertion were enrolled in our study. The patients were randomly allocated to the tube-exchanger group or the control group. The number of attempts, the time required for successful NGT insertion, and the complications were noted for each patient.
  
  
  RESULTS
  In the tube-exchanger group, the success rate of NGT insertion on the first attempt was 92%, which is significantly higher than 68%, the rate in the control group (P = 0.007). The time required for successful NGT insertion in the tube-exchanger group was 18.5 ± 8.2 seconds, which is significantly shorter than the control group, 75.1 ± 9.8 seconds (P < 0.001). Complications such as laryngeal bleeding and the kinking and knotting of the NGT occurred less often in the tube-exchanger group.
  
  
  CONCLUSIONS
  There were many advantages in using a tube-exchanger as a guide to inserting NGTs in anesthetized and intubated patients. Compared to the conventional technique, the use of a tube-exchanger resulted in a higher the success rate of insertion on the first attempt, a shorter procedure time, and fewer complications.
authors.affiliation: Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Hyae-Jin
authors.identifier: 0000-0003-1444-1125
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.; Research Scientist, Medical Research Institute, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Hyeon Jeong
authors.identifier: 0000-0002-3450-865X
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Myungeun Hospital, Busan, Korea.
authors.forename: Hyun-Jun
authors.initials: HJ
authors.lastname: Cho
authors.affiliation: Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Hae-Kyu
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Ah-Reum
authors.initials: AR
authors.lastname: Cho
authors.affiliation: Department of Anesthesia and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Narae
authors.initials: N
authors.lastname: Oh
keywords: Digestive system surgical procedures; Gastrointestinal intubation; Preoperative care