An improved biologically transparent illumination system that increases the accuracy of detecting the correct position of a nasogastric tube in the stomach.

The aim of this study was to determine whether an improved biologically transparent illumination system results in more reliable detection of the correct position of the nasogastric tube in surgical patients. In total, 102 patients undergoing general surgery were included in this prospective observational study. After general anesthesia, all patients were inserted a nasogastric tube equipped with an improved biologically transparent illumination catheter. Identification of biologically transparent light in the epigastric area indicated successful insertion of the nasogastric tube into the stomach. The position of the tube was confirmed by X-ray examination, and its findings were compared with those of the biologically transparent illumination system. We observed biologically transparent light in epigastric area in 87 of the 102 patients. X-ray examination revealed that the nasogastric tube was placed in the stomach in all of these 87 patients. Light was not observed in the remaining 15 patients; the tube position was confirmed in the stomach in 11 of these patients but not in the other 4 by X-ray examination. Illumination had a sensitivity of 88.8% and a specificity of 100%. Our results suggest that this improved biologically transparent illumination system increased the accuracy of detecting the correct position of a nasogastric tube in the stomach. X-ray examination is required to check the position of the nasogastric tube in patients when biologically transparent illumination light is negative.

Biologically transparent illumination is a safe, fast, and simple technique for detecting the correct position of the nasogastric tube in surgical patients under general anesthesia.

The aim of this study was to evaluate the effectiveness of using biologically transparent illumination to detect the correct position of the nasogastric tube in surgical patients. This prospective observational study enrolled 102 patients undergoing general surgeries. In all cases, a nasogastric tube equipped with a biologically transparent illumination catheter was inserted after general anesthesia. The identification of biologically transparent light in the epigastric area either with or without finger pressure indicated that the tube had been successfully inserted into the stomach. X-ray examination was performed to ascertain the tube position and was compared with the findings of the biologically transparent illumination technique. Biologically transparent light was detected in 72 of the 102 patients. In all of these 72 patients, the position of the nasogastric tube in the stomach was confirmed by X-ray examination. The light was not detected in the other 30 patients; X-ray examination showed that the nasogastric tube was positioned in the stomach in 21 of these 30 patients but not in the other 9. The sensitivity and specificity of the illumination were 77.4% and 100%, respectively. The results suggest that biologically transparent illumination is a useful and safe technique for detecting the correct position of the nasogastric tube in surgical patients under general anesthesia. When the BT light cannot be identified, X-ray examination is mandatory to confirm the position of the nasogastric tube.

A case of failed awake craniotomy due to progressive intraoperative hyponatremia.

BACKGROUND: Perioperative seizure control is correlated with a better surgical outcome for awake craniotomy, but some anticonvulsants can induce hyponatremia. Mannitol has also been reported to be hyponatremic. CASE PRESENTATION: A 51-year-old right-handed man had malignant glioma in the left parietal lobe. Since anticonvulsant polytherapy did not stop his seizure activity, the daily dose of carbamazepine was increased beginning 17 days before awake craniotomy. The last preoperative blood examination indicated that his plasma sodium level had gradually decreased from 140 to 130 mEq/L. Following skin incision, 200 mL of 20% mannitol was administered and his plasma sodium level subsequently dropped to 117 mEq/L. The surgical strategy was changed so that the entire procedure would be performed under general anesthesia because severe intraoperative complications were anticipated. CONCLUSIONS: This case suggests that a perioperative electrolyte imbalance caused by drug interactions could be clinically significant for awake craniotomy.