Japanese Journal of Nursing Art and Science

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　Naso-gastric tube feeding is widely used in clinical settings in Japan, but there are some problems. Sometimes it is difficult to insert the tube smoothly, and the tube courses spirally or oblique in the pharynx pressing the epiglottis. Thick tube of 14Fr or 16Fr also presses the epiglottis, disturbing the swallowing movement. The authors experienced that the tube went smoothly through the pharynx and placed correctly avoiding the epiglottis when the patients neck was rotated. The present paper studied insertion methods of the nasal-gastric tube.
　Subjects and Methods : 81 person average age of 76.8 years old, who needed tube feeding were informed and gave consent for the trial. We tried tube insertion with and without neck rotation and compared the tube insertion success rate. A total 159 trials were performed. We checked the course of the tube in the pharynx, whether ipsilateral course to the inserted nostril or not, using fiberoptic endoscopy.
　Results : The success rate of tube insertion with the neck rotation method was 92％ and that without neck rotation was 59％ (p＜0.05). The rate of ipsilateral course of tube with the neck rotation method was 67％, while that without neck rotation was 55％ (p＜0.05).
　Discussion : We think that neck rotation changes the shape of pharynx and reduces the resistance of the upper esophageal sphincter, which makes naso-gastric tube insertion easy. This method saves time and removes many troubles and is good for both patients and medical staff.
　Conclusion : The new insertion technique for the naso-gastric tube using neck rotation proved to be successful.

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