ORIGINAL ARTICLE   

Minerva Anestesiologica 2020 April;86(4):416-22

DOI: 10.23736/S0375-9393.19.14076-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

The Orogastric Tube Guide® as a novel strategy for gastric tube insertion: a prospective, randomized controlled clinical trial

Marc KRIEGE ¹, Florian HEID ¹ ✉, Christian ALFLEN ¹, Irene SCHMIDTMANN ², Frank DETTE ¹, Ruediger NOPPENS ³, Tim PIEPHO ⁴

¹ Department of Anesthesiology, University Medical Center, Johannes Gutenberg University, Mainz, Germany; ² Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University, Mainz, Germany; ³ Department of Anesthesia and Perioperative Medicine, Western University, London, ON, Canada; ⁴ Department of Anesthesiology and Intensive Care Medicine, Hospital of Barmherzigen Brüder, Trier, Germany

BACKGROUND: Gastric tube insertion, either orally or nasally, is daily practice in anesthesia and intensive care. “Blind” insertion represents the common conventional method and is associated with low first-pass success and frequent complications. This trial aimed to evaluate the novel gastric tube guide as a rigid conduit in regard to insertion success rate, time required and associated complications versus the conventional “blind” insertion method. We hypothesized that the insertion success rate is higher using the Orogastric tube guide.
METHODS: This trial was approved by ethics committee prior to patient recruitment. In a randomized order, anesthetists performed oral insertion of a gastric tube either with the Orogastric tube guide (GTG) or by conventional “blind” technique (CONV) in elective surgical patients. Exclusion criteria were defined as age under 18 years, pregnancy, emergency surgery and patients without indication for tracheal intubation and gastric tube insertion.
RESULTS: We examined 151 patients (GTG, N.=71; CONV, N.=80). The success rate was higher with the GTG compared to the conventional method (69/71 (97%) vs. 61/80 (76%); P<0.001). The median insertion time was 25 s (IQR 20-39) using the GTG and 31 s (IQR 24-58; P=0.027) with the conventional method. We found no differences with regard to complications between the groups (P=0.54).
CONCLUSIONS: Our findings suggest that the use of the GTG facilitates and fastens orogastric tube placement in anesthetized patients and thereby constitutes a benefit in clinical routine.

KEY WORDS: Perioperative period; Equipment and supplies; Gastrointestinal intubation