Nasogastric Tube Insertion in Intubated Patients: Comparison of Three Different Positions; Standard Sniffing Position, Additional Flexion of the Neck, and Standard Sniffing Position with Lateral Neck Pressure

Objective: Our study aimed to evaluate two modified nasogastric tube (NGT) insertion techniques in intubated patients compared to the conventional method in respect of first attempt success rate, time taken for insertion, and complications. Methods: In this prospective interventional study, patients with orotracheal intubation requiring NGT insertion were randomly allocated into three groups by SNOS Group A (control group- standard sniffing position, n = 40), Group B (additional flexion of the neck, n = 40), Group C (standard sniffing position with lateral neck pressure, n = 40). The number of attempts for successful NGT insertion, time for insertion, and complications were compared. Results: Modified positions showed a high first-attempt success rate in Group B (55%) and Group C (85%) as compared to conventional Group A (32.50%) (P < 0.001). On intergroup analysis of modified groups (B and C), Group C was superior to Group B in 1st attempt success rate with a significant P value of 0.003. Conclusion: In intubated patients, NGT insertion in standard sniffing position with lateral neck pressure has the highest first attempt success rate followed by additional flexion of neck position. Both the modified positions are better positions for NGT insertion in intubated patients.