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Novel Visual Nasogastric Tube Insertion System: A Feasibility and Efficiency Study in a Manikin.

ABSTRACT: Background. Conventional nasogastric tube placement is an essential clinical procedure; however, complications may arise from blind manipulation. We tested the feasibility and efficiency of a visual nasogastric tube insertion system (VNGS) using a manikin. Methods. A microimaging fiber (0.8?mm) was integrated into the nasogastric tube to create the VNGS. Twenty inexperienced physicians were enrolled and assigned to the visual or conventional group. Each physician performed 10 repeated nasogastric tube insertions with visual guidance or the conventional method; another 20 inexperienced medical students received nasogastric tube insertion training using visual guidance or the conventional method. Results. The nasogastric tube successfully reached the stomach and the narrow anatomic structures were visualized with the VNGS. Time required for insertion was significantly shorter in the visual group compared to the conventional group (22.56 ± 3.08 versus 37.30 ± 4.12 seconds, P < 0.001). Tube misplacement was observed in 19/100 cases (19%) in the conventional group; no misplacement was observed in the visual group. Less mucosal damage was noted in the visual group (3.43 ± 1.63 versus 9.86 ± 2.31?cm²). Medical students performed better NGT insertions (shorter insertion time and less procedure-related complications) after undergoing the visual guidance training. Conclusions. The VNGS may provide a new technique for nasogastric tube insertion applicable to clinical use or simulation training.

SUBMITTER: Li Q

PROVIDER: S-EPMC5141553 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Novel Visual Nasogastric Tube Insertion System: A Feasibility and Efficiency Study in a Manikin.

Li Qiaoya Q Xie Juan J Wu Jinxing J Guo Rui R Ma Wenwen W Xu Gang G Yang Min M Deng Huisheng H

Gastroenterology research and practice 20161123

<i>Background</i>. Conventional nasogastric tube placement is an essential clinical procedure; however, complications may arise from blind manipulation. We tested the feasibility and efficiency of a visual nasogastric tube insertion system (VNGS) using a manikin. <i>Methods</i>. A microimaging fiber (0.8 mm) was integrated into the nasogastric tube to create the VNGS. Twenty inexperienced physicians were enrolled and assigned to the visual or conventional group. Each physician performed 10 repea ...[more]

PMID: 27994620

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Project description:BackgroundNasogastric (NG) tube insertion is a common procedure in the clinical setting that causes much discomfort and pain for the patient. Pain control is often suboptimal, as many NG tube insertions are performed without any pain-relieving supplements. The aim of this study was to summarize and critically evaluate the evidence from randomized controlled trials (RCTs) on the effect and adverse effects of lidocaine agents in reducing pain and discomfort associated with NG tube insertion.MethodsDatabases from the Cochrane Library, MEDLINE, EMBASE, Airiti Library, PerioPath Index to Taiwan Periodical Literature, and Cumulative Index of Nursing and Allied Health (CINAHL) were searched from inception to April 2017. RCTs focusing on lidocaine before NG tube insertion were appraised. The primary outcome was the visual analog scale (VAS) score. The modified Jadad scale was used for quality assessment. Mean difference (MD) with 95% confidence intervals (95% CIs) and odds ratio (OR) for binary outcomes were assessed by a random effects model. Heterogeneity was determined by using the Cochran Q test and I statistics. Publication bias was analyzed by using a funnel plot analysis.ResultsTen RCTs enrolling 734 patients were included in the meta-analysis. Eight of the 10 RCTs reporting VAS scores had sufficient quantitative data to be pooled through meta-analysis. Results revealed a significant reduction in VAS score, with a MD of -26.05 and a CI of -28.21 to -23.89 with moderate heterogeneity (P?<?.001, I?=?56%). There were no significant changes in difficulty of NG tube insertions (MD?=?-0.30, 95% CI, -1.30 to 0.70, P?=?.55), number of NG tube insertion attempts (MD?=?-0.22, 95% CI, -0.98 to 0.53, P?=?.56), nasal bleeding (OR?=?0.62, 95% CI, 0.11-3.41, P?=?.59), and vomiting (OR?=?0.30, 95% CI, 0.07-1.27, P?=?.10).ConclusionThis meta-analysis suggests that applying lidocaine before NG tube insertion can alleviate pain and discomfort by 26% without increasing nasal bleeding or vomiting.

Dataset Information

Novel Visual Nasogastric Tube Insertion System: A Feasibility and Efficiency Study in a Manikin.

Publications

Novel Visual Nasogastric Tube Insertion System: A Feasibility and Efficiency Study in a Manikin.

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