Efficacy of tracheal and gastric tube consecutive insertion under videolaryngoscopy in reducing complications associated with gastric tube insertion: a randomized controlled trial.

Insertion of a gastric tube in anesthetized patients is frequently difficult. The "consecutive insertion method", in which a videolaryngoscope is inserted, a tube is inserted to the trachea and a gastric tube insertion guide (with a gastric tube in it) to the esophagus before removing the videolaryngoscope, may reduce complications associated with insertion of a gastric tube. Sixty patients were randomly allocated to the consecutive insertion method (in group C) and blind method (in group B), to compare the incidence of complications, the success rate, and insertion time. The incidence of complications was significantly lower in group C than in group B (2 vs. 12 patients) (P = 0.002). There was no significant difference in the success rate of insertion of a gastric tube between groups B and C (25 vs. 30 patients) (P = 0.052). The median apnea time was significantly longer in group C (46 vs. 35 s) (P = 0.00052), whereas the median total insertion time was significantly shorter in group C (117 vs. 138 s) (P = 0.015). Compared with blind insertion of a gastric tube, consecutive insertion of a tracheal tube and a gastric tube (through an insertion guide) would reduce the incidence of complications.