Background:  Nasogastric tube (NGT) insertion is indicated almost routinely in patients undergoing abdominal surgery to decompress the stomach  perioperatively. Insertion of NGT in anaesthetised, intubated patients with  conventional method is sometimes difficult. Different techniques of NGT insertion have been tried with varying degree of success.

Method: Sixty patients under general anesthesia and orotracheally intubated were studied . The patients were randomized into two groups: Head in Neutral position and Head turned to Right side. The starting point of the procedure was the time  when NGT insertion was begun through the selected nostril. If failed second attempt was tried with external laryngeal manipulation. The end point was the time when there was either a successful insertion of the NGT or a failure after two attempts. The success rate of the technique, duration of insertion procedure and the occurrence of complications (bleeding, coiling etc.) were noted.

Results: In neutral position first attempt success rate of insertion was 20% and increased to 90% with external laryngeal manipulation. In head turned Right group first attempt success rate was 46.7% which increased to 90% with external laryngeal manipulation. First attempt success rate was significantly higher (p < 0.05) in head turned right position.

Conclusion: NGT insertion is easier when NGT is inseted after turning the patient’s head to right. External laryngeal manipulation makes NGT insertion easier.