Immediate oral feeding after nasogastric tube removal - Tips from Other Journals

Date: June, 1992

The use of nasogastric tubes after abdominal procedures has been standard surgical practice for many years. Recently, the utility of postoperative nasogastric decompression has been questioned. Classic postoperative management after nasogastric tube removal has included gradual oral feeding starting with liquids and progressing to solid food after 48 to 72 hours. Bickel and colleagues performed a prospective randomized study to evaluate the safety of immediate initiation of solid foods after removal of nasogastric tubes.

The study included 171 patients who underwent gastrointestinal surgery and had nasogastric tubes placed postoperatively. After tube removal, patients were randomized to receive solid foods immediately or to receive liquids immediately followed by gradual introduction of solid foods.

Patients ranged in age from 18 to 90 years; the mean age was about 60 years. A nearly equal number of males and females were included in both groups. Surgical procedures performed included small bowel anastomosis, Whipple's procedure, gastroenterostomy, ileocolonic anastomosis and pyloroplasty. The amount of nasogastric aspirate did not affect tube removal, with 13 patients having more than 1,000 mL of aspirate on the day before the nasogastric was removed.

The authors found no significant differences in morbidity and mortality between the two groups. The number of gastrointestinal complications, the rate of reinsertion and the length of hospitalization were the same in both groups. The authors conclude that introducing solid foods immediately after nasogastric tube removal in patients who have undergone abdominal surgery appears to be safe and well tolerated. (Archives of Surgery, March 1992, vol. 127, p. 287.)

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