Nasogastric Tube Use in Children after Abdominal Surgery – How long should it be Kept <i>in Situ?</i>

Abstract

BACKGROUND: Traditionally, the use of a nasogastric tube (NGT) after a laparotomy is said to prevent vomiting, aspiration, abdominal distension and paralytic ileus, which are likely to complicate the postoperative course.
OBJECTIVE: To determine if discontinuation of NGT within 24 hours of abdominal surgical procedures in children has any effect on postoperative recovery.
MATERIALS AND METHODS: We prospectively studied children who needed NGT passed for abdominal surgical procedures. NGTs were removed within 24 hours in all but 46 children who had the tube in situ for 3 to 5 days. Time to first and full oral feeds, length of hospital stay and complications
were compared between the groups.
RESULTS: Children who had their NGTs removed within 24 hours (N = 120, Group 1) were compared with those who had NGT in place for 3 to 5 days (N = 46, Group 2). The mean time to first oral sips was 1.02 ± 0.13 days for Group 1 and 3.09 ± 0.29 days for Group 2 (p = 0.001). The mean time to full feeding was 2.22 ± 0.54 days for Group 1 and 4.54 ± 0.55 days for
Group 2 (p = 0.001). Mean length of hospital stay (LOHS) was 8.32 ± 5.49 days for Group 1 and 12.78 ± 8.79 days for Group 2 (p = 0.001). Mean LOHS was 9.55 ± 6.85 days for both groups combined. Ten complications associated with the removal of the NGT occurred in both groups– 6 in Group 1 and 4 in Group 2 (p = 0.37). These were mainly vomiting and abdominal
distension.
CONCLUSION: Our findings suggest that routine use of NGTs for  decompression after laparotomy may be safely dispensed with after the child has recovered from anaesthesia. WAJM 2012; 31(1): 19–23.

Keywords: Nasogastric tube, paediatric, laparotomy, abdomen, protocol, surgical procedure