RecruitingACTRN12623000341628

Use of Nasogastric Tubes in Adult Patients with Small Bowel Obstruction

A Randomised Clinical Trial to Assess the Use of Nasogastric Tubes in Adult Patients with Adhesive Small Bowel Obstruction for Prevention of Operative Intervention.

Sponsor

Hunter New England Local Health District

Enrollment

480 participants

Start Date

Nov 1, 2023

Study Type

Interventional

Conditions

small bowel obstruction intestinal obstruction

Summary

This study looks at the use of the nasogastric tube in the management of small bowel obstruction in patients with a history of abdominal surgery. The null hypothesis is that not using the nasogatric tube results in an more operations than the nasogastric tube. Small bowel obstruction is a surgical emergency and at its worst can result in the death of a patient due to small bowel infarction. The accepted standard of care is insertion of a nasogastric tube to decompress a distended stomach. There is little if any research evidence to support this practice and this study seeks to compare this practice to not using a nasogastric tube and observe if it results in less patients having srugery to the condition.

Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Inclusion Criteria4

Patients 18 years and over.
Past history of abdominal surgery.
Radiological evidence of small bowel obstruction.
Direct presentation to the hospital from home or usual place for residence.

Exclusion Criteria12

Are unable to give written informed consent to take part in the study, or do not have a designated person responsible that can provide consent until the participant is well enough to consent for themselves.
Patients who require the use of a trained healthcare interpreter and present after hours when a trained health care interpreter may not be available in a timely manner.
Patients readmitted with SBO within follow-up time-points of study.
Patients transferred from other hospitals
Patient who has had a nasogastric tube inserted by other staff prior to surgical review, eg Emergency Department Senior Medical officer.
Known malignancies that may cause obstruction.
Radiological evidence of a mass lesion causing obstruction.
Obstruction caused by hernias.
Radiological evidence of need for urgent surgery based on ischaemic small intestine.
Pregnant females.
Recent history of aspiration pneumonia
Patients not considered to have a survivable condition.

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Interventions

No nasogastric tube, in addition to standard care which may include intravenous fluids, analgesia, anti-emetics, and/or surgery as determined by surgeon in charge based on progress of signs and symptoms of bowel onstruction including radiological changes. Adherence to ransomisation will be recorded from the medical record.