Effectiveness of left nasal nasogastric tube placement with right head-tilt in anesthetized patients: a randomized controlled trial.

Background: Patients undergoing general anesthesia frequently encounter difficulties when the conventional nasogastric tube (NGT) is placed, resulting in low success rates. This study investigates a novel, free-hand, and blind technique aimed at enhancing the first-attempt success rate without the need for any medium.

Methods: One hundred and thirty-two eligible patients were randomly allocated to either the experimental group or the control group. In the experimental group, patients' heads were turned 45-90° to the right while in the supine position, and the NGT was inserted vertically through the left nasal cavity. In the control group, patients remained in a neutral supine position. All other procedures were the same between the two groups.

Results: The experimental group had a significantly higher one-time success rate than the control group, 82.54% (52/63) versus 67.18% (43/64) (relative risk = 2.309; 95% CI: 1.003-5.315; P=0.046). There was no significant difference in complications (15.87% versus 28.13%; P=0.096) or in the time taken for placement and changes in vital signs between the groups.

Conclusions: Placing the NGT through the left nasal cavity with the head turned right in supine patients under general anesthesia significantly improves the one-time success rate without increasing complications.