Tuesday, August 3, 2021

NG tubes for SBO

First10EM - By Justin Morgenstern. August 2, 2021
“Bottom Line
This is clearly a harmful procedure. Patients consider it more painful than almost anything else we do in medicine. That harm means that we must have evidence of benefit before we can consider this practice ethical. At this point, there is no evidence, and therefore NG tubes absolutely should not be placed routinely in patients with small bowel obstructions.
That conclusion doesn’t mean that NG tubes don’t provide any benefit. Evidence on the topic is essentially non-existent. We just don’t know. But we know the tubes cause harm, and therefore the burden of proof lies without those who want to subject patients to that harm. Before NG tubes are used, we must demonstrate that there is a benefit that outweighs the known harm. If NG tubes are as important as surgeons seem to think – if there is a huge absolute benefit – then it should be very easy to demonstrate that benefit in an RCT. However, until we see that RCT, it is unfair to patients to subject them to this unproven, painful procedure.”