Gastric tube insertion under visual control with the use of the Pentax-AWS®

Ikeno, Shigeo; M, Nagano; Tanaka, Satoshi; Nishimura, Chieko; Kawamata, Tomoyuki; Kawamata, Mikito

doi:10.1007/s00540-011-1133-4

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…The use of videolaryngoscopes can improve the success rate for NGT insertion. [ 7 – 11 ] However, an NGT cannot be directed to the esophagus using videolaryngoscopes alone. In addition, because videolaryngoscopes provide a narrower visual field compared with the Macintosh laryngoscope, clinicians often encounter difficulty in maintaining the forcep tips within the monitor.…”

Section: Discussionmentioning

confidence: 99%

“…Videolaryngoscopes facilitate easy intubation and also enable clear visualization of both the larynx and esophageal inlet. Some investigators have reported the efficacy of the Pentax-AWS [ 7 – 9 ] (Hoya, Tokyo, Japan) and Glidescope [ 10 , 11 ] (Verathon, Bothell, WA) for NGT insertion. However, although these videolaryngoscopes enabled visualization of the hypopharynx or the piriform fossa, they could not direct the tip of the NGT to the esophageal inlet, regardless of the attachment of an endotracheal tube guide.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of a curved forceps with a conventional straight forceps for nasogastric tube insertion under videolaryngoscopic guidance

Furutani

Watanabe²,

Kamiya³

et al. 2017

Medicine

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Background:Nasogastric tube (NGT) insertion is an easy procedure that can be routinely performed under general anesthesia. However, for difficult cases, there are limited insertion techniques available in routine clinical practice, considering the flexibility of NGTs. The SUZY curved forceps are designed for the removal of pharyngolaryngeal foreign bodies under guidance of the McGRATH MAC (McG) videolaryngoscope. Because McG enables clear visualization of the esophageal inlet, we hypothesized that the SUZY forceps can facilitate easier NGT insertion compared with the conventional Magill forceps under McG guidance and designed a randomized, crossover manikin study to test this hypothesis.Materials and Methods:Ten anesthesiologists participated in this study. Each participant was instructed to insert an NGT using either the SUZY or the Magill forceps under McG guidance. Both types of forceps were used by each participant in a computer-generated random order. The primary outcome measure was the number of “strokes” (1 stroke was defined by a specific sequence of participant actions) required to advance the NGT 30 cm from the starting point. Data are expressed as medians (interquartile ranges [ranges]).Results:The number of strokes required for NGT insertion was fewer in the SUZY group than in the Magill group {7 [7.0–12.5 (5–14)] vs 16.5 [13.5–20.3 (7–22)]; P <.05}. The time required for NGT insertion was also lesser in the SUZY group than in the Magill group {15.4 [13.7–20.0 (7.0–38.3)] seconds vs 30.3 [22.0–42.3 (12.8–47.5) seconds]; P <.05}.Conclusions:The SUZY curved forceps facilitated NGT insertion more effectively than the Magill straight forceps under McG guidance. Our results suggest that NGT insertion using the SUZY forceps under McG guidance is a secure and easy procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of a curved forceps with a conventional straight forceps for nasogastric tube insertion under videolaryngoscopic guidance

Furutani

Watanabe²,

Kamiya³

et al. 2017

Medicine

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“…Malpositioning of the gastric tube in the trachea will certainly be detected under direct visualization using a video laryngoscope, especially if it is used during insertion. Ikeno and colleagues reported that use of the Pentax-AWS system™ (Air Way Scope, AWS; Hoya, Tokyo, Japan) helped to prevent misplacement of the gastric tube into the trachea [ 9 ]. Kitagawa and colleagues also found that the AWS device reduced the incidence of oral damage caused by blind insertion, and recommended that a pediatric AWS blade be used to allow better maneuverability around the endotracheal tube in the oropharynx [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Gastric tube insertion under direct vision using the King Vision™ video laryngoscope: a randomized, prospective, clinical trial

et al. 2014

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BackgroundThe frequency of malpositioning of gastric tubes in the trachea has been reported to be 0.3–15%, which may cause severe complications, such as pneumonia, if not detected promptly. If a gastric tube can be guided into the esophagus under direct vision with a video laryngoscope, misplacement of the gastric tube into the trachea can be avoided. We compared gastric tube insertion under direct vision using a video laryngoscope with the conventional method of blind insertion.MethodsWe enrolled 60 patients who required a transnasal gastric tube to facilitate elective abdominal surgery under general anesthesia. The participants were recruited consecutively into one of two groups, a group of 30 patients in whom a gastric tube was inserted using a King Vision™ video laryngoscope (KV group), and a group of 30 patients who underwent conventional blind insertion of the gastric tube (Blind group). The success rate, the time taken to insert the gastric tube, and the incidence of complications were compared.ResultsIn the KV group, the time required for gastric tube placement was 52.5 ± 17.1 seconds, with a success rate of 100%. Slight oral hemorrhage occurred in two participants and slight epistaxis in one participant. In the Blind group, the time required for gastric tube placement was 65.9 ± 39.9 seconds, with a success rate of 90% (27 out of 30 patients). Slight oral hemorrhage occurred in two participants, slight epistaxis occurred in two participants, and tracheal malposition occurred in one participant but was detected promptly and corrected using the video laryngoscope. There were no significant differences in the time required for placing the gastric tube, the success rate, or the incidence of complications between the groups.ConclusionsGastric tube insertion using a King Vision video laryngoscope was straightforward, and was particularly useful for detecting and correcting tracheal malpositioning.Trial registrationTrial registry number: UMIN000011014.

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“…Although videolaryngoscopes, such as the Glidescope TM (Verathon, Bothell, WA) [ 9 – 11 ] or Pentax-AWS TM (Hoya, Tokyo, Japan), [ 12 – 15 ] may allow both visualization of the esophageal inlet and facilitation of NGT insertion, they cannot direct the tip of the NGT to the esophageal inlet. In fact, NGT insertion using the King Vision TM (King Systems, Indianapolis, IN) failed to demonstrate significant benefit over blind insertion.…”

Section: Introductionmentioning

confidence: 99%

SUZYTM forceps facilitate nasogastric tube insertion under McGRATHTM MAC videolaryngoscopic guidance

et al. 2020

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Background: Nasogastric tubes can be easily inserted in patients under general anesthesia. However, for difficult cases, insertion techniques that can be used in routine clinical practice are limited. SUZY forceps are designed for the removal of pharyngolaryngeal foreign bodies under guidance of a McGrath videolaryngoscope. We hypothesized that using SUZY forceps under McGrath videolaryngoscopic guidance may facilitate nasogastric tube insertion and tested this in a randomized controlled trial. Methods: Adult patients who underwent gastrointestinal or hepato-pancreato-biliary surgery were randomly allocated to 2 groups; the SUZY group and the Magill group. Patients, nurses, and all clinical staff except for the attending anesthesiologist were blinded to group assignment throughout the study. After anesthesia induction, insertion of the nasogastric tube was performed by skilled anesthesiologists with either SUZY or Magill forceps according to group allocation under McGrath videolaryngoscopic guidance. The primary endpoint was insertion time which was defined as the time required to advance the nasogastric tube by 55 cm from the nostril. Secondary endpoints were the success rates of the nasogastric tube insertion, which were defined as a 55-cm advancement from the nostril at the 1st, 2nd, and 3rd attempt, proper insertion rate, the severity of pharyngolaryngeal complications, and hemodynamic parameters during nasogastric tube insertion. Results: Sixty patients were randomized and none of these patients were excluded from the final analysis. The median [interquartile range] insertion time was 25 [18–33] seconds in the SUZY group, and 33 [21–54] seconds in the Magill group ( P = .02). Success rates were not different between the groups (97% and 80% in the SUZY and Magill group at 1st attempt, respectively, P = .10). Both, the severity score of the mucosal injury and the severity of sore throat were higher in the Magill than in the SUZY group, whereas the degree of hoarseness did not differ between the 2 groups. Hemodynamic parameters were not significantly different between the groups. Conclusion: Using SUZY forceps under McGrath videolaryngoscopic guidance reduced the time required to insert a nasogastric tube and the severity of pharyngolaryngeal complications, when compared to using Magill forceps.

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Gastric tube insertion under visual control with the use of the Pentax-AWS®

Cited by 7 publications

References 5 publications

Comparison of a curved forceps with a conventional straight forceps for nasogastric tube insertion under videolaryngoscopic guidance

Comparison of a curved forceps with a conventional straight forceps for nasogastric tube insertion under videolaryngoscopic guidance

Gastric tube insertion under direct vision using the King Vision™ video laryngoscope: a randomized, prospective, clinical trial

SUZYTM forceps facilitate nasogastric tube insertion under McGRATHTM MAC videolaryngoscopic guidance

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