TITLE:
Intraoperative Gastric Tube Intubation: A Summary of Case Studies and Review of the Literature
AUTHORS:
Michael Long, Melissa Machan, Luis Tollinche
KEYWORDS:
Nasogastric Tube, Orogastric Tube, Gastric Tube, Perioperative, Intraoperative, Anesthesia, Blind Insertion
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.7 No.3,
March
17,
2017
ABSTRACT: Study Objective: Establish complications and risk
factors that are associated with blind tube insertion, evaluate the validity of
correct placement verification methods, establish the rationales supporting its
employment by anesthesia providers, and describe various deployment
facilitators described in current literature. Measurements: An exhaustive
literature review of the databases Medline, CINAHL, Cochrane Collaboration,
Scopus, and Google Scholar was performed applying the search terms “gastric tube”, “complications”, “decompression”, “blind insertion”, “perioperative”, “intraoperative” in various order sequences. A five-year limit was
applied to limit the number and timeliness of articles selected. Main Results:
Patients are exposed to potentially serious morbidity and mortality from
blindly inserted gastric tubes. Risk factors associated with malposition
include blind insertion, the presence of endotracheal tubes, altered sensorium,
and previous tube misplacements. Pulmonary aspiration risk prevention remains
the only indication for anesthesia-related intraoperative use. There are no
singularly effective tools that predict or verify the proper placement of
blindly inserted gastric tubes. Current placement facilitation techniques are
perpetuated through anecdotal experience and technique variability warrants
further study. Conclusion: In the absence of aspiration risk factors or the
need for surgical decompression in ASA classification I & II patients, a
moratorium should be instituted on the elective use of gastric tubes.