Nasogastric Intubation Periprocedural Care

Updated: May 13, 2022
  • Author: Gil Z Shlamovitz, MD, FACEP; Chief Editor: Vikram Kate, MBBS, MS, PhD, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FFST(Ed), FIMSA, MAMS, MASCRS  more...
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Periprocedural Care


The following equipment is needed for nasogastric (NG) intubation (see the image below):

  • NG tube (for adult patients) - 16-18 French
  • NG tube (for pediatric patients) - In pediatric patients, the correct tube size varies with the patient's age; to find the correct size (in French), add 16 to the patient's age in years and then divide by 2, so that for an 8-year-old child, for example, the correct size is 12 French ([8 + 16]/2 = 12)
  • Viscous lidocaine 2%
  • Oral analgesic spray (benzocaine spray or other)
  • Syringe, 10 mL
  • Glass of water with a straw
  • Water-based lubricant
  • Toomey syringe, 60 mL
  • Tape
  • Emesis basin or plastic bag
  • Wall suction, set to low intermittent suction
  • Suction tubing and container
Equipment for nasogastric intubation. Equipment for nasogastric intubation.

Patient Preparation


Various methods of topical anesthesia for NG intubation have been proved to be effective in pain relief and to improve the likelihood of successful NG intubation. [7, 8, 9, 10, 11]

The use of viscous lidocaine (ie, the sniff and swallow method) was found to significantly reduce the pain and gagging sensation associated with NG tube insertion. [12]  Viscous lidocaine is discussed in more detail in the Technique section below.

Alternative techniques include the following:

  • Nebulization of lidocaine 1% or 4% through a face mask (≤ 4 mg/kg; not to exceed 200 mg per dose in adults) is an option; the authors recommend that a preservative-free lidocaine (ie, intravenous lidocaine) be used for nebulization in order to minimize the risk of allergic reaction
  • An anesthetic spray that contains benzocaine or a tetracaine/benzocaine/butyl aminobenzoate combination may be applied to the nasal and oropharyngeal mucosa; be advised that incidents of methemoglobinemia after a single use of benzocaine topical sprays have been reported to the US Food and Drug Administration (FDA); for more information, see  Anesthesia, Topical


The patient should be seated in an upright position.