2021, Vol. 4, Issue 1, Part C

Gastric decompression and reduction in gastric volume is routinely practiced in clinical anaesthesiology and intensive care medicine and the use of oro-gastric tube to achieve decompression is widely known technique. Nonetheless, this may be challenging and is concomitant with severe complications including but not restricted to failure to pass the oro-gastric tube beyond crico-pharynx, coiling in oral cavity, upper airway trauma, laryngeal injuries, esophageal perforation, bleeding and post procedure throat discomfort. In clinical anaesthesiology and in intensive care medicine the orogastric tube insertion is mostly done after general anaesthesia induction. The procedure becomes all the more challenging due to the attenuation of airway reflexes and loss of consciousness rendered by general anaesthesia. The present study was conducted in the department of Anaesthesiology and Critical Care at a tertiary care center of Armed Forces to evaluate if the usage of the new gastric tube guide would ease and accelerate the placement of oro-gastric tube while simultaneously reducing the complications arising out of the procedure.

Material and Methods: The present study is a first randomized controlled study done on live patients. The study was conducted on the patients undergoing elective laparoscopic surgery who required gastric decompression as the part of the procedure at the Department of Anaesthesiology and Critical Care, of a tertiary care hospital of armed forces.

Study Design: Prospective randomized controlled study.

Study Location: Tertiary care hospital of armed forces.

Study Duration: Aug 2019 to Aug 2020.

Sample Size: 100 patients.

Subject and Selection Method: After taking ethical approval of the institute and informed consent from patients hundred patients aged between 18 to 65 years of either sex, accepted in Mallampati classification I and II and without any obvious airway abnormalities who were scheduled for elective laparoscopic surgery and required gastric decompression as a part of procedure were included in the study. The participants were then randomly assigned to one of the two groups of 50 patients each to undergo oro-gastric tube insertion using gastric tube guide and those without it.

Results: Passage of the oro-gastric tube was successful during the first pass in 38 patients (76%) in the Group A i.e. gastric tube guide group against 15 (30%) patients in the group B i.e. non-gastric guide group. (4%) patients in Group A required three or more attempts against 11 (22%) patients Group B. The mean time taken for the passage of the oro-gastric tube successfully in the Group A was 21.90 ± 16.33 against 80.14 ± 49.78 secs in the group B (p<0.001). The results obtained support the observation that passage of the oro-gastric tube with the gastric tube guide is associated with a higher success rate in first attempt than without it. Moreover, it also shows that the time duration for securing oro- gastric tube is significantly low using gastric tube guide.

Conclusion: The present study it was found that use of gastric tube guide avoids the shambolic and arduous measures of failed nasogastric tube insertions while significantly reducing the duration of procedure.