Routine versus selective postoperative nasogastric suction in Mulago Hospital

Abstract

Background: Nasogastric suction is a common routine postoperative procedure in abdominal surgery. Yet there is little scientific justification for it. This paper reports a comparision of routine with selective postoperative nasogastric tube suction in evaluating patients undergoing laparotomy.

Methods: This was a prospective study of 55 elective patients who were randomised into two groups: Group I (n = 27) had postoperative nasogastric tube as a routine for drainage till patients passed flatus. Group II (n = 28) selectively had postoperative nasogastric tube when deemed necessary. Both groups were followed up postoperatively for outcome variables till discharge or stitch removal.

Results: There were two failures (7.1%) in group II both of whom were diabetics. There were significant sodium losses on the postoperative days 1, 2 and 3 (p=0.026, 0.014 and 0.045 respectively) in group I compared to group II. There were significantly more cases of postoperative sore throat, nose bleeding, nausea, cough and other minor postoperative complications in group I than group II (respective p-values of 0.037, 0.004, 0.002, 0.015 and 0.031). Group I significantly took longer to get back the bowel sounds and to be discharged compared to group II (p-values <0.001).

Conclusion: Postoperative selective nasogastric suction following abdominal surgery is safe and associated with reduction in postoperative morbidity; quicker recovery and shorter hospital stay than routine nasogastric suction.