eP51 Introducing the Use of Local Anaesthetic Spray for the Insertion of Nasogastric Tubes in Emergency General Surgery

Aims

Nasogastric tube (NGT) insertion is a common procedure used within Emergency General Surgery for patients who present with small bowel obstruction. As per current clinical guidelines, this is typically carried out without any analgesic agents, which has anecdotally resulted in reports of pain, nausea and distress from patients.

A service improvement project was undertaken to determine if using local anaesthetic (Xylocaine) spray can also improve the patient experience of having a NGT inserted with the aim of introducing a Patient Group Directive (PGD) for its use.

Methods

46 patients were given a questionnaire prospectively asking them to rate their experience of pain, nausea/vomiting and distress/anxiety following successful insertion of NGTs. Half of the group had Xylocaine spray administered prior to insertion. They were asked to rate their experiences of pain, nausea and distress on a Likert scale of 1-5 (5 being severe), as well as provide any other feedback.

Results

When prior experience was compared to the experience where Xyloxaine spray was used, fewer patients reported pain, nausea and distress at the severe end of the scale. Qualitative feedback also suggested that using Xylocaine spray improved the experience for many patients through alleviating pain to the nose and throat.

Conclusion

Local anaesthetic spray can improve the experience of pain, nausea and anxiety when undergoing NGT insertion, and numerous studies support its use. A PGD and Clinical Guideline for its use is now underway with the aim to improve patient experience and increase compliance with this intervention.