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Emergency physicians’ practices and attitudes regarding procedural anaesthesia for nasogastric tube insertion
  1. G A Juhl,
  2. G P Conners
  1. Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
  1. Correspondence to:
 Dr G P Conners
 Department of Emergency Medicine, 601 Elmwood Avenue, Box 655, Rochester, NY 14642, USA;


Objective: To determine practice and attitudes of emergency physicians regarding procedural anaesthesia for nasogastric tube insertion (NGT).

Methods: Survey of resident/attending emergency physicians working in a tertiary care medical centre.

Results: Of 68 physicians, 46 responded: 98% believed that awake and alert patients find NGT insertion uncomfortable/painful; 93% used measures to reduce this, most commonly lubricant gel, topical anaesthetic spray, lidocaine gel, and distraction/use of a child life worker; 28% believed these provided adequate pain control and 37% believed they were inadequate. Topical anaesthetic spray, lidocaine gel, and nebulised/atomised anaesthetics were believed the most practical to administer and 44% actually used these. Nebulised/atomised anaesthetics, systemic anxiolytics, and topical anaesthetic spray were believed the most effective at pain control but only 24% actually used these. While 39% of respondents were satisfied with their current practice, 46% were dissatisfied: 91% would change their practice if new literature were to show a convenient way to effectively reduce this pain.

Conclusions: Emergency physicians do not actually use the measures they believe are most practical/most effective at reducing the pain associated with NGT insertion. Thus, there may be a barrier to the use of these measures. Improvement in procedural anaesthesia for NGT insertion in emergency departments is needed and desired by emergency physicians.

  • nasogastric tube
  • nasogastric intubation
  • procedural anaesthesia
  • pain

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  • Competing interests: none declared