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BackgroundA nasogastric tube (NGT) is commonly inserted into patients undergoing abdominal surgery to decompress the stomach during or after surgery. However, for anatomic reasons, the insertion of NGTs into anesthetized and intubated patients may be challenging. We hypothesized that the use of a tube exchanger for NGT insertion could increase the success rate and reduce complications.MethodsOne hundred adult patients, aged 20–70 years, who were scheduled for gastrointestinal surgeries with general anesthesia and NGT insertion were enrolled in our study. The patients were randomly allocated to the tube-exchanger group or the control group. The number of attempts, the time required for successful NGT insertion, and the complications were noted for each patient.ResultsIn the tube-exchanger group, the success rate of NGT insertion on the first attempt was 92%, which is significantly higher than 68%, the rate in the control group (P = 0.007). The time required for successful NGT insertion in the tube-exchanger group was 18.5 ± 8.2 seconds, which is significantly shorter than the control group, 75.1 ± 9.8 seconds (P < 0.001). Complications such as laryngeal bleeding and the kinking and knotting of the NGT occurred less often in the tube-exchanger group.ConclusionsThere were many advantages in using a tube-exchanger as a guide to inserting NGTs in anesthetized and intubated patients. Compared to the conventional technique, the use of a tube-exchanger resulted in a higher the success rate of insertion on the first attempt, a shorter procedure time, and fewer complications.

This study was carried out to establish an effective marketing strategy based on Importance-Performance Analysis (IPA) of rice-convenience foods. IPA is one of the most efficient and simple methods to evaluate product quality. Data were collected from 652 people (320 males and 332 females) and analyzed by SPSS 19.0. Subjects consumed rice-convenience foods as a snack substitute (19.3%), breakfast (20.7%), lunch (37.4%), dinner (15.2%), and late-night meal (7.4%). The purpose for consumption of rice-convenience foods were as follows: light meal (34.8%), lack of time to prepare meal (42.2%), favorite restaurant is not nearby (2.3%), save money (3.4%), and outdoor activities (9.7%). All attributes about rice-convenience foods were categorized into intrinsic property and extrinsic property. As a result of factor analysis, health, sensibility, and diversity factors were extracted from intrinsic property. In addition, dependence and appearance factors were drawn from extrinsic property. In analyzing the differences between importance and performance, there were significant differences; 16 items in the intrinsic property (P<0.01), and 10 items in the extrinsic property (P<0.001). The IPA matrix is composed of four quadrants, and each represents different strategies; the first, 'keep up the good work', the second, 'possible overkill', the third, 'low priority for management', and the fourth, 'concentrate management'. As a result, factors of rice-convenience foods positioned in the fourth quadrant were 'safety (from food additives, etc.)' and 'price' in the intrinsic property and 'nutrition label' and 'safety of packaging material' in the extrinsic property. They need to be improved immediately. In this study, rice-convenience food factors for continuous maintenance and concentrative improvement were compared by IPA. Based upon the results of this study, it is necessary to develop methods to make efficient use of limited resources and practical marketing strategies.

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