Reducing the pain of nasogastric tube intubation with nebulized and atomized lidocaine: A systematic review and meta-analysis

Ya Wen Kuo, Miao-Fen Yen, Susan Fetzer, Jiann Der Lee

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Nasogastric tube (NGT) intubations occur frequently in clinical practice and can be a painful procedure for patients. A systematic review of current knowledge concerning the use of nebulized lidocaine to reduce the pain of NGT insertion was conducted in order to develop evidence-based guidelines. In addition, a meta-analysis of appropriate randomized controlled trials (RCTs) was performed. The databases included PubMed (1996-2009), ProQuest (1982-2009), CINAHL (1982-2009), and the Cochrane Central Register of Controlled Trials (2009), and reference lists of articles. Experts in this field also were contacted. Two investigators selected the research based on inclusion criteria and reviewed each study's quality according to the Jadad scale. Five RCTs with 212 subjects were identified. A total of 113 (58%) subjects were women. The mean age of treatment and control groups was 59.6 and 55 years, respectively. The countries of studies were the United States, United Kingdom, Australia, Canada, and Thailand. In the treatment groups, the use of lidocaine concentration was 4% and 10%. The pooled effect size was 0.423 (95% confidence interval: 0.204-0.880; Z = -2.301; P = 0.021), indicating that the use of nebulized lidocaine before NGT insertion can decrease pain by 57.7%. There is insufficient evidence to recommend the dosage, concentration, or delivery method. Further research is needed to articulate a comprehensive clinical guideline.

Original languageEnglish
Pages (from-to)613-620
Number of pages8
JournalJournal of Pain and Symptom Management
Volume40
Issue number4
DOIs
Publication statusPublished - 2010 Oct 1

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Gastrointestinal Intubation
Lidocaine
Meta-Analysis
Pain
Randomized Controlled Trials
Guidelines
Thailand
Research
PubMed
Canada
Age Groups
Research Personnel
Databases
Confidence Intervals
Control Groups
Therapeutics

All Science Journal Classification (ASJC) codes

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

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title = "Reducing the pain of nasogastric tube intubation with nebulized and atomized lidocaine: A systematic review and meta-analysis",
abstract = "Nasogastric tube (NGT) intubations occur frequently in clinical practice and can be a painful procedure for patients. A systematic review of current knowledge concerning the use of nebulized lidocaine to reduce the pain of NGT insertion was conducted in order to develop evidence-based guidelines. In addition, a meta-analysis of appropriate randomized controlled trials (RCTs) was performed. The databases included PubMed (1996-2009), ProQuest (1982-2009), CINAHL (1982-2009), and the Cochrane Central Register of Controlled Trials (2009), and reference lists of articles. Experts in this field also were contacted. Two investigators selected the research based on inclusion criteria and reviewed each study's quality according to the Jadad scale. Five RCTs with 212 subjects were identified. A total of 113 (58{\%}) subjects were women. The mean age of treatment and control groups was 59.6 and 55 years, respectively. The countries of studies were the United States, United Kingdom, Australia, Canada, and Thailand. In the treatment groups, the use of lidocaine concentration was 4{\%} and 10{\%}. The pooled effect size was 0.423 (95{\%} confidence interval: 0.204-0.880; Z = -2.301; P = 0.021), indicating that the use of nebulized lidocaine before NGT insertion can decrease pain by 57.7{\%}. There is insufficient evidence to recommend the dosage, concentration, or delivery method. Further research is needed to articulate a comprehensive clinical guideline.",
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Reducing the pain of nasogastric tube intubation with nebulized and atomized lidocaine : A systematic review and meta-analysis. / Kuo, Ya Wen; Yen, Miao-Fen; Fetzer, Susan; Lee, Jiann Der.

In: Journal of Pain and Symptom Management, Vol. 40, No. 4, 01.10.2010, p. 613-620.

Research output: Contribution to journalReview article

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