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Updated: Jun 14, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Ketamine improves nasogastric tube insertion.

Amir Nejati¹, Keihan Golshani, Maziar Moradi Lakeh

¹Sina Hospital, Imam Khomeini Street, Tehran, Iran.

Emergency Medicine Journal : EMJ

|April 3, 2010

Summary

Intranasal ketamine significantly reduced pain during nasogastric (NG) tube insertion compared to standard lubrication alone. This study found intranasal ketamine to be an effective pain management option for NG intubation in the emergency department.

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Last Updated: Jun 14, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Area of Science:

Emergency Medicine
Pain Management
Anesthesiology

Background:

Nasogastric (NG) intubation is a common emergency department procedure.
Pain associated with NG intubation necessitates effective pain management strategies.

Purpose of the Study:

To compare pain levels during NG tube insertion using intranasal ketamine with a lubricating gel versus lubricating gel alone.
To evaluate the analgesic efficacy of ketamine for NG intubation in the ED.

Main Methods:

A prospective, double-blind, randomized clinical trial involving 72 adult patients requiring NG intubation.
Patients were randomized to receive either intranasal ketamine or sterile water, followed by standard lubrication and NG tube insertion.
Pain was assessed using a visual analogue scale (VAS), and procedure difficulty was rated on a Likert scale.

Main Results:

The ketamine group reported significantly lower pain scores (19.03) compared to the control group (33.33) on the VAS.
No statistically significant difference was observed in the difficulty of the procedure between the two groups.
Seventy-two patients were enrolled, with 36 in each group.

Conclusions:

Intranasal ketamine is an effective method for reducing pain associated with nasogastric tube insertion.
The findings support the use of intranasal ketamine as an analgesic adjunct in emergency settings for NG intubation.