A preinstalled nasopharyngeal airway in the right nasal passageway to facilitate nasogastric intubation in anesthetized and intubated patients: a prospective randomized controlled trial

Abstract Background Nasogastric intubation (NGI) is usually challenging in patients under general anesthesia, with reported success rate at the first attempt to be less than 50%. The aim of this study was to investigate whether a preinstalled nasopharyngeal airway (NPA) in the right nasal passageway can facilitate NGI in anesthetized and intubated patients. Methods A prospective randomized controlled trial including 108 patients scheduled for elective intra-abdominal surgeries requiring a nasogastric tube (NGT) was conducted. Fifty-three patients were randomized to receive NGI through a preinstalled NPA in the right nasal passageway (Group NPA) and 55 patients to receive NGI via the right nostril (Group O). The primary outcomes were success rates of NGI at first attempt, success rates of NGI in accumulative attempts, durations of successful NGI at the first attempt and success rates of NGI for the rescuing methods. The secondary outcomes were bleeding incidence and hemodynamic changes induced by NGI. Results Success rate of NGI at the first attempt was 83.0% in Group NPA compared with 47.3% in Group O [P < 0.001; absolute risk reduction (ARR) = 35.7%, 95% confidence interval (CI) = 19.1–52.4%; relative risk reduction (RRR) = 67.8%] and success rate of NGI in accumulative attempts (two attempts maximum) was 88.7% in Group NPA compared with 63.6% in Group O (P = 0.002; ARR = 25.0%, 95% CI = 9.7–40.4%; RRR = 68.9%). Duration for NGI successful at the first attempt in Group NPA was significantly longer than that in Group O (56.3 vs. 27.1 s; P < 0.001; Mean difference = 29.2 s, 95% CI = 20.0–38.4 s). Neither bleeding incidence nor hemodynamic response is significantly different between the two study groups. Conclusions The study indicates a preinstalled NPA in the right nasal passageway facilitates NGI in anesthetized and intubated patients as an initial NGI method and as a rescuing method for patients undergoing two unsuccessful initial attempts of NGI without a preinstalled NPA. However, the NPA method proved to take more time than the routine method for NGI successful at the first attempt. Trial registration: The study was conducted after receiving approval from Institutional Review Board of Chang Gung Memorial Hospital, Linkou branch, Taiwan (registration number 201800138A3; April 11, 2018), and the clinicaltrials.gov (NCT03697642; Principal Investigator: Ting-Yang Huang; Date of registration: October 4, 2018; https://www.clinicaltrials.gov/NCT03697642).

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Efficacy of repeat forward‐view examination of the right‐sided colon during colonoscopy: A prospective randomized controlled trial

Journal of Gastroenterology and Hepatology ◽

10.1111/jgh.15064 ◽

2020 ◽

Vol 35 (10) ◽

pp. 1746-1752

Author(s):

Su Young Kim ◽

Sang Jin Lee ◽

Jun‐Won Chung ◽

Kwang An Kwon ◽

Kyoung Oh Kim ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial ◽

The Right

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Prospective, Randomized, Controlled Trial of a Hemostatic Sealant in Children Undergoing Adenotonsillectomy

Otolaryngology ◽

10.1016/j.otohns.2006.09.020 ◽

2007 ◽

Vol 137 (3) ◽

pp. 454-458 ◽

Cited By ~ 30

Author(s):

Stephen H. Jo ◽

Ronald A. Mathiasen ◽

Deepak Gurushanthaiah

Keyword(s):

Randomized Controlled Trial ◽

Blood Loss ◽

Postoperative Morbidity ◽

Controlled Trial ◽

Safety And Efficacy ◽

Randomized Controlled ◽

Pain Medications ◽

Prospective Randomized Controlled Trial ◽

Cold Knife ◽

To Receive

OBJECTIVES: To evaluate the efficacy of Floseal as a hemostatic sealant compared to traditional electrocautery hemostasis after cold knife adenotonsillectomy. STUDY DESIGN: Prospective, randomized, controlled trial of 68 consecutive patients undergoing cold steel adenotonsillectomy. Patients were randomized to receive either Floseal (FS) or electrocautery (EC) for hemostasis. RESULTS: FS patients had shorter operative times than EC patients (16 min vs 31.2 min, P < 0.0001) and less blood loss (49.2 mL vs 70.8 mL, P < 0.05). Four EC patients were crossed over to Floseal when adequate hemostasis could not be achieved in the adenoid bed. No Floseal patients were crossed over. FS patients had significantly less pain on postoperative days two through 11 ( P < 0.05) and less use of narcotic pain medications over the first 10 postoperative days ( P < 0.05). FS patients also had a faster return to regular diet (5.5 days vs 7.9 days, P < 0.01) and activity (5.3 days vs 7.8 days, P < 0.01) as compared to the EC patients. There were no significant complications in either group. CONCLUSIONS: Floseal is safe and efficacious, and decreases postoperative morbidity as compared to electrocautery hemostasis after cold steel adenotonsillectomy. SIGNIFICANCE: This study demonstrates the safety and efficacy of Floseal as a hemostatic method in children undergoing adenotonsillectomy.

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Clinical performance of Ambu AuraGainTM versus i-gelTM in anesthetized children: a prospective, randomized controlled trial

Anesthesia and Pain Medicine ◽

10.17085/apm.2020.15.2.173 ◽

2020 ◽

Vol 15 (2) ◽

pp. 173-180

Author(s):

Ji-Hyun Lee ◽

Seungpyo Nam ◽

Young-Eun Jang ◽

Eun-Hee Kim ◽

Hee-Soo Kim ◽

...

Keyword(s):

Randomized Controlled Trial ◽

General Anesthesia ◽

Clinical Performance ◽

Controlled Trial ◽

Catheter Placement ◽

Suction Catheter ◽

Success Rates ◽

Emergence Period ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial

Background: Ambu AuraGain and i-gel have different characteristics in design each other. However, few reports evaluate which device has more benefits for ventilation in children undergoing paralyzed general anesthesia. This prospective, randomized controlled trial compared the clinical performance AuraGain and i-gel in anesthetized children.Methods: Children aged between 1 month and 7 years undergoing elective surgery were randomly assigned to the AuraGain and i-gel groups. The primary outcome was initial oropharyngeal leak pressure (OLP). Secondary outcomes were OLP at 10 min post-insertion, first-attempt and total insertion success rates, number of attempts and ease of gastric suction catheter placement, peak inspiratory pressure, fiberoptic bronchoscopic view score, ventilation quality, requirement of additional manipulation post-insertion, and complications.Results: Data of 93 patients were analyzed. The initial OLPs of the AuraGain and i-gel were 27.5 ± 7.7 and 25.0 ± 8.0 cmH2O, respectively (P = 0.13). The OLP was significantly increased 10 min post-insertion in both groups. The initial success rates of the AuraGain and i-gel insertion were comparable. Suction catheter placement via the gastric port was easier (P = 0.02) and fiberoptic bronchoscopic view was better with the AuraGain (P < 0.001). The i-gel required additional manipulations post-insertion (P = 0.04). The incidence of complications during the emergence period was 2.2% for the i-gel and 10.8% for the AuraGain (P = 0.1)Conclusions: OLP is comparable between AuraGain and i-gel. The AuraGain would be more favorable than the i-gel for use in pediatric patients under general anesthesia considering other outcomes.

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Feasibility of Wet and Non-Wet Placement of Seprafilm in Laparoscopic Surgeries: A Randomized Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm10163526 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3526

Author(s):

Chun-Shuo Hsu ◽

Dah-Ching Ding

Keyword(s):

Randomized Controlled Trial ◽

Laparoscopic Surgery ◽

Success Rate ◽

Controlled Trial ◽

Preparation Time ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial ◽

Application Methods ◽

Methods Of Application

Seprafilm becomes brittle and sticky after contact with water, rendering it difficult to use in laparoscopic surgery. Hence, Seprafilm is not used frequently in laparoscopic surgery. This prospective randomized controlled trial aimed to compare the feasibility of two methods of application of Seprafilm: wet and non-wet. Two groups comprised 30 patients, each with 180 pieces of Seprafilm. Symptomatic patients who underwent laparoscopic surgeries, including hysterectomy and adnexal surgeries, were recruited. Successful application of Seprafilm was defined as a smooth attachment to the site of application. Sticky and fractured Seprafilm sheets were defined as failed applications. Between March 2016 and December 2017, 60 patients underwent laparoscopic Seprafilm placement. The preparation time was 32.67 ± 16.63 and 79.50 ± 22.01 s in the non-wet and wet groups, respectively (p < 0.00). The success rate of application was 95.4% in the non-wet group and 98.3% in the wet group (p = 0.09). Placement time was 599.50 ± 90.18 s and 592.53 ± 105.82 s in the non-wet and wet groups, respectively (p = 0.25). In conclusion, the wet and non-wet application methods of Seprafilm were feasible in laparoscopic surgeries. The preparation time was different between the two groups. However, the rate of successful application and placement time was not different between the two groups.

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