Different gastric tube placement techniques in intubated adults: a randomized trial

Background: The reverse Sellick maneuver helps to widen the esophagus by moving the cricoid cartilage forward, which makes it easier to insert the nasogastric tube smoothly. This study aimed to evaluate the effectiveness of the reverse Sellick maneuver for nasogastric tube placement in patients with tracheal intubation. Methods: This trial enrolled 66 patients who were intubated and admitted to the intensive care unit of a tertiary hospital in China between July 2022 and December 2023. The experimental group underwent nasogastric tube insertion using the reverse Sellick maneuver, while the control group received the traditional insertion technique. The success rates of tube placement, the durations of the procedures, and the incidence of adverse events were compared between the two groups. Results: The reverse Sellick maneuver demonstrated a success rate of 96.9% compared to 93.9% in the traditional technique (p = 1.000). Mean placement times were 9 minutes in the experimental group and 7 minutes in the control group (p = 0.892). The maximum number of placement attempts was three in the experimental group and four in the control group (p < 0.001). Accidental tracheal entry occurred in one case in the experimental group versus four cases in the control group. We found a reduction in nasogastric tube twisting or knotting with the reverse Sellick maneuver (p < 0.05) and no differences in nasal bleeding and accidental tracheal entry (p > 0.05). Conclusions: The reverse Sellick maneuver provides a comparable success rate to the traditional technique for nasogastric tube placement in intubated patients, with a potential reduction in serious adverse events. Clinical Trial Registration: The clinical trial registration was completed with the registration number: ChiCTR2200063982.