ABSTRACT
Abstract Background Nasogastric tube insertion may be difficult in anesthetized and intubated patients with head in the neutral position. Several techniques are available for the successful insertion of nasogastric tube. The primary aim of this study was to investigate the difference in the first attempt success rate of different techniques for insertion of nasogastric tube. Secondary aim was to investigate the difference of the duration of insertion using the selected technique, complications during insertion such as kinking and mucosal bleeding. Material and methods 200 adult patients, who received general anesthesia for elective abdominal surgeries that required nasogastric tube insertion, were randomized into four groups: Conventional group (Group C), head in the lateral position group (Group L), endotracheal tube assisted group (Group ET) and McGrath video laryngoscope group (Group MG). Success rates, duration of insertion and complications were noted. Results Success rates of nasogastric tube insertion in first attempt and overall were lower in Group C than Group ET and Group MG. Mean duration and total time for successful insertion of NG tube in first attempt were significantly longer in Group ET. Kinking was higher in Group C. Mucosal bleeding was statistically lower in Group MG. Conclusion Use of video laryngoscope and endotracheal tube assistance during NG tube insertion compared with conventional technique increase the success rate and reduce the kinking in anesthetized and intubated adult patients. Use of video laryngoscope during nasogastric tube insertion compared to other techniques reduces the mucosal bleeding in anesthetized and intubated adult patients.
Resumo Justificativa A inserção de sonda nasogástrica (NG) pode ser difícil em pacientes anestesiados e intubados com a cabeça em posição neutra. Há várias técnicas para a inserção bem-sucedida de sonda NG. O objetivo primário deste estudo foi investigar a diferença da taxa de sucesso na primeira tentativa de diferentes técnicas para inserção de sonda NG. O objetivo secundário foi investigar a diferença do tempo de inserção com o uso da técnica selecionada e as complicações durante a inserção (dobradura da sonda e sangramento da mucosa). Material e métodos 200 pacientes adultos que receberam anestesia geral para cirurgias abdominais eletivas que exigiam inserção de sonda NG foram randomicamente distribuídos em quatro grupos: grupo convencional (Grupo C), grupo com a cabeça posicionada lateralmente (Grupo L), grupo com assistência de tubo traqueal (Grupo TE) e grupo com videolaringoscópio McGrath (grupo MG). As taxas de sucesso, os tempos de inserção e as complicações foram registrados. Resultados As taxas de sucesso de inserção da sonda NG na primeira tentativa e em geral foram menores no Grupo C do que nos grupos TE e MG. As durações e os tempos totais de inserção bem-sucedida da sonda NG na primeira tentativa foram significativamente maiores no Grupo TE. Dobradura foi maior no Grupo C. Sangramento da mucosa foi estatisticamente menor no Grupo MG. Conclusão O uso de videolaringoscópio e de TE durante a inserção de sonda NG comparado com o uso da técnica convencional aumentou a taxa de sucesso e reduziu a dobradura da sonda em pacientes adultos anestesiados e intubados. O uso de videolaringoscópio durante a inserção de sonda NG em comparação com outras técnicas reduz o sangramento da mucosa em pacientes adultos anestesiados e intubados.
Subject(s)
Humans , Male , Female , Intubation, Gastrointestinal/methods , Anesthesia , Intubation, Gastrointestinal/adverse effects , Intubation, Intratracheal , Laryngoscopy , Middle AgedABSTRACT
BACKGROUND: Nasogastric tube insertion may be difficult in anesthetized and intubated patients with head in the neutral position. Several techniques are available for the successful insertion of nasogastric tube. The primary aim of this study was to investigate the difference in the first attempt success rate of different techniques for insertion of nasogastric tube. Secondary aim was to investigate the difference of the duration of insertion using the selected technique, complications during insertion such as kinking and mucosal bleeding. MATERIAL AND METHODS: 200 adult patients, who received general anesthesia for elective abdominal surgeries that required nasogastric tube insertion, were randomized into four groups: Conventional group (Group C), head in the lateral position group (Group L), endotracheal tube assisted group (Group ET) and McGrath video laryngoscope group (Group MG). Success rates, duration of insertion and complications were noted. RESULTS: Success rates of nasogastric tube insertion in first attempt and overall were lower in Group C than Group ET and Group MG. Mean duration and total time for successful insertion of NG tube in first attempt were significantly longer in Group ET. Kinking was higher in Group C. Mucosal bleeding was statistically lower in Group MG. CONCLUSION: Use of video laryngoscope and endotracheal tube assistance during NG tube insertion compared with conventional technique increase the success rate and reduce the kinking in anesthetized and intubated adult patients. Use of video laryngoscope during nasogastric tube insertion compared to other techniques reduces the mucosal bleeding in anesthetized and intubated adult patients.
Subject(s)
Anesthesia , Intubation, Gastrointestinal/methods , Female , Humans , Intubation, Gastrointestinal/adverse effects , Intubation, Intratracheal , Laryngoscopy , Male , Middle AgedABSTRACT
BACKGROUND: Long-term occupational exposure to trace concentrations of volatile anesthetics is known to have adverse effects on the health of exposed personnel. OBJECTIVES: We investigated paraoxonase-1 (PON1) and arylesterase (ARE), as well as antioxidant status (TAS) and total oxidant status (TOS) levels in anesthesia personnel (AP) who were chronically exposed to inhalation anesthetics, and compared them with levels in a control group. MATERIAL AND METHODS: We designed a comparative prospective study with 50 female subjects. The first cohort included 25 full-time female workers in operating rooms in two locations in the Antalya Education and Research Hospital in Antalya, Turkey. The control group was comprised of 25 female individuals working in the same hospitals without any work-related exposure to hazardous agents. RESULTS: Serum ARE activity and TAS levels were significantly reduced (p = 0.04 and p < 0.0001, respectively), whereas TOS and OSI levels were found to be significantly higher (p = 0.01 and p < 0.0001, respectively) in AP. However, there were no significant differences in PON1 activity, PON1/HDL-C, ARE/HDL-C, and PON1/ARE (p = 0.30, p = 0.5, p = 0.1 and p = 0.7, respectively) when the two groups were contrasted. CONCLUSIONS: According to the results of this study, depending on the putative role of PON/ARE in oxidant stress-related diseases, particularly atherosclerosis and cancer, AP might be considered a risk group for the development of atherosclerosis and many other diseases.
