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

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.