Comparing the effectiveness of c-mac video laryngoscope™ and reverse sellick's techniques to the blind method for nasogastric tube insertion in anesthetized, intubated patients: A randomized controlled trial

Background: Nasogastric tube (NGT) insertion in the perioperative period is a common procedure undertaken by the anesthesiologist. The conventional technique of insertion is associated with a higher failure rate under anesthesia. Additional maneuvers and instrumentation are required for a successful insertion. In this study, we evaluated the effectiveness of the C-MAC ™ video laryngoscope system with the conventional and reverse Sellick's methods for the insertion of NGT. Methods: In this prospective randomized controlled trial, participants aged 18–70 years who underwent elective surgeries requiring NGT insertion were randomized into three groups. The primary outcome was the first-attempt success rate. The secondary outcomes measured were the time taken for a successful first attempt, complication rate, and ease of insertion. Results: 120 patients were enrolled in the study. The C-MAC ™ group had a higher first-attempt success rate (95 %) compared to the reverse Sellicks group (77.5 %) and the conventional group (70 %) (P = 0.014). The time taken for a successful first attempt was highest in the C-MAC ™ group (C-MAC vs. reverse Sellick's vs. conventional; 34.71 ± 5.94 vs. 18.66 ± 7.42 vs. 21.06 ± 6.09; P < 0.001). The C-MAC ™ group reported the least complications and had the highest satisfaction rate compared to the three methods. Conclusions: Employing a C-MAC video laryngoscope for insertion of NGT provides a higher success rate with the least number of complications compared to other techniques.