Nasogastric tube (NGT) placement in anesthetized and intubated is sometimes very challenging with more than 50% failure rate in the first attempt. We describe a newer innovative Sahu's three in one, technique with use of GlideScope and forward placement of intubated trachea by external laryngeal maneuver, these both techniques lead to separation of trachea from esophagus so that endoscopic jejunal feeding tube guide wire strengthen NGT can be guided and manipulated to esophagus under direct vision. After informed consent, we used Sahu's three in one combo technique to insert NGT in adult anesthetized and intubated patients of both the sexes with high success in the first attempt. We found this technique easy, helpful, less time consuming with high success rate.
Glomus jugulare tumor is a type of paraganglioma which has an association with catecholamine secretion but only in < 5% of cases. Any such occult or undetected catecholamine-secreting tumor poses anesthetic challenges in the perioperative period. A routine catecholamine assay and rigorous hemodynamic monitoring in such cases minimize perioperative anesthetic complications.
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