Inflation with air via a facepiece for facilitating insertion of a nasogastric tube: a prospective, randomised, double-blind study

Insertion of a nasogastric tube is a routine procedure but during anaesthesia it is often difficult and time consuming. One hundred and sixty adults undergoing elective surgery under general anaesthesia were randomly divided into two groups. After induction of anaesthesia, neuromuscular blockade and tracheal intubation, a nasogastric tube was inserted through the nose with the head of the patient in the neutral position, either with or without prior inflation with air via a facepiece attached to a self-inflating bag applied firmly with the face. Insertion of the nasogastric tube was successful in 75/78 (96%) following inflation compared with 54/80 (68%) without inflation (p < 0.001). In four patients receiving inflation, a fibreoptic endoscope was passed as far as the upper oesophageal sphincter; this revealed opening of the upper oesophageal sphincter during inflation.