POSTOPERATIVE NASOGASTRIC DECOMPRESSION - A PROSPECTIVE RANDOMIZED TRIAL

To determine which type of patient should receive routine postoperativ e nasogastric decompression (NGD), we observed 76 patients who were ra ndomized into two groups: those who received routine NGD (n = 39) and those who received selective NGD (n = 37), Eighteen patients in the se lective NGD group never required intubation, while 19 did require intu bation within a mean of 3 days after surgery. in both groups, tubes re mained in place for a mean of 4.7 days. The routine NGD group had a 2. 5% incidence of emesis, while the selective NGD group had a 51% incide nce of emesis. The return of bowel function, return to a regular diet, and postoperative length of hospital stay were similar in both groups . The patients in the selective NGD group who did not require intubati on had a shorter postoperative stay. Fifty-eight percent of patients i n the selective NGD group who required intubation had had major vascul ar or retroperitoneal dissections. These data support selective use of NGD in general surgical patients and routine use of NGD for patients having major retroperitoneal or vascular procedures.