• Gao-Wen Ou, Heng Li, Bing Shao, Li-Ming Huang, Guo-Min Chen, and Wei-Chao Li.
• Department of Anesthesiology, Qingyuan People's Hospital, The Six Affiliated Hospital of Guangzhou Medical University, Qingyuan 511518, Guangdong Province, China. wenzhemami@163.com.
• World J Clin Cases. 2021 Sep 16; 9 (26): 7772-7785.

BackgroundSeveral techniques of nasogastric tube (NGT) insertion have been described in the literature with different success rates.AimTo systematically search the literature and conduct a meta-analysis comparing the success rates, insertion time and complications associated with different techniques of NGT insertion in anesthetized and intubated patients.MethodsAn electronic search of the PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar databases were performed up to October 31, 2019. We included 17 randomized controlled trials with 2500 participants in the meta-analysis.ResultsAs compared to the conventional method, successful insertion of the NGT on first attempt was higher with modified techniques such as the reverse Sellick's maneuver [relative risk (RR) 1.94; 95% confidence interval (CI): 1.62-2.31], use of a frozen NGT (RR 1.55; 95%CI: 1.13-2.13), inserting the NGT with neck flexion and lateral neck pressure (RR 1.64; 95%CI: 1.10-2.45), endotracheal tube-assisted (RR 1.88; 95%CI: 1.52-2.32) and video-assisted placements (RR 1.60; 95%CI: 1.31-1.95). All the modified techniques also led to comparatively higher insertion success rates than the conventional technique.ConclusionThe use of modified techniques of NGT insertion such as the reverse Sellick's maneuver, neck flexion with lateral neck pressure, frozen NGT, endotracheal tube-guided or video-assisted methods result in a significantly better chance of successful tube insertion at first attempt as compared to the conventional technique. All modified techniques also significantly improve the overall chance of successful NGT placement as compared to the conventional method.©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

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