Effect of different gastrointestinal decompression methods during general anesthesia: a randomized controlled trial.

OBJECTIVE: During general anesthesia with drainage laryngeal mask airway (LMA) ventilation, a gastric tube or suction catheter is inserted through the drainage LMA hole during surgery. This allows for gastrointestinal decompression by vacuum aspiration. This study aimed to observe the effect of two decompression methods on the incidence of postoperative flatulence, nausea and vomiting, and other adverse reactions in patients undergoing general anesthesia. METHODS: Sixty patients (ASA I-II, aged 18-70 years) undergoing gynecological surgery with LMA ventilation under general anesthesia were randomly categorized into the gastric tube group (group G) and the suction catheter group (group S). After induction of general anesthesia, a gastric tube or suction catheter was placed through the drainage port of the drainage LMA in both groups, and vacuum aspiration was intermittently performed during the surgery. The antral area was monitored under ultrasound at three time points: after admission, after LMA insertion, and after LMA. Also, the incidence of adverse reactions, such as flatulence, and nausea and vomiting, was followed up at 1, 6, and 24 h after the surgery. RESULTS: Compared with group G, the antral area in group S increased significantly after the surgery (P < 0.05). In addition, the incidence of nausea and vomiting, and flatulence, in group S significantly increased 1 and 6 h after the surgery (all P < 0.05). No significant difference was observed in the incidence of nausea and vomiting, and flatulence, between the two groups 24 h after the surgery. No significant difference was noted in the incidence of sore throat and hoarseness at three time points after the surgery between the two groups. CONCLUSIONS: Under general anesthesia with drainage LMA ventilation, gastrointestinal decompression with a gastric tube placed through the LMA drainage port could effectively prevent flatulence and reduce the incidence of adverse reactions such as nausea and vomiting. The placement of a suction catheter could not achieve the same clinical effect. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry,registration number ChiCTR2300078990,22/12/2023.