Endotracheal Tube Suctioning Versus No Suctioning During Emergence From General Anesthesia
NCT ID: NCT07287293
Last Updated: 2026-01-12
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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RECRUITING
NA
408 participants
INTERVENTIONAL
2026-01-05
2027-03-31
Brief Summary
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The study addresses the following questions:
* Primary outcome (non-inferiority):
* Is the risk of postoperative desaturation (oxygen saturation \[SpO₂\] \<92% within 60 minutes after extubation) in the no-suction group not worse than in the routine-suction group by more than 10 percentage points?
* Secondary outcomes (superiority):
* Does omitting tracheal suctioning reduce postoperative cough severity and sore throat?
* Does omitting tracheal suctioning avoid increasing extubation-related adverse events?
Participants will be randomly assigned (1:1) to one of two groups:
* Routine suctioning (SUC): Endotracheal suctioning plus oropharyngeal suctioning immediately before extubation
* No suctioning (NON-SUC): Oropharyngeal suctioning only, without endotracheal suctioning
All participants will receive standard anesthetic care and postoperative monitoring in the post-anesthesia care unit (PACU) for 60 minutes. Follow-up for airway symptoms and patient satisfaction will be conducted at 24 hours after surgery.
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
Routine Suctioning Group (SUC):
Participants received both endotracheal suctioning and oropharyngeal suctioning immediately prior to extubation, performed using standard suction pressure and technique.
No Suctioning Group (NON-SUC):
Participants received oropharyngeal suctioning only. No suction catheter was inserted into the trachea prior to extubation.
If the anesthesiologist identified copious airway secretions requiring clearance for patient safety, endotracheal suctioning was performed. These participants were subsequently excluded from the analysis as per the predefined protocol.
SUPPORTIVE_CARE
SINGLE
Study Groups
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Routine Endotracheal Suctioning (SUC)
Participants in this arm received routine endotracheal suctioning immediately prior to extubation, performed using standard suction pressure and technique. Oropharyngeal suctioning was also performed according to usual clinical practice.
Routine Endotracheal Suctioning
Endotracheal suctioning performed immediately prior to extubation using standard suction pressure and technique. Oropharyngeal suctioning was also performed according to routine clinical practice.
Omission of Endotracheal Suctioning (NON-SUC)
Participants in this arm received oropharyngeal suctioning only prior to extubation. No suction catheter was inserted into the trachea. Standard anesthetic care and monitoring were provided as per routine practice.
Omission of Endotracheal Suctioning
Oropharyngeal suctioning only was performed prior to extubation. No suction catheter was inserted into the trachea.
Interventions
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Routine Endotracheal Suctioning
Endotracheal suctioning performed immediately prior to extubation using standard suction pressure and technique. Oropharyngeal suctioning was also performed according to routine clinical practice.
Omission of Endotracheal Suctioning
Oropharyngeal suctioning only was performed prior to extubation. No suction catheter was inserted into the trachea.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Scheduled for elective surgery under general anesthesia requiring endotracheal intubation.
* Planned tracheal extubation in the operating room at the end of surgery.
Exclusion Criteria
* Known diagnosis of obstructive sleep apnea (OSA), active pneumonia, or chronic pulmonary disease (e.g., chronic obstructive pulmonary disease, restrictive lung disease).
* Body mass index (BMI) \>35 kg/m².
* Pregnancy or increased aspiration risk (e.g., full stomach).
* Scheduled for maxillofacial, head and neck, or airway surgery.
* Anticipated surgical duration \>3.5 hours.
* Anticipated difficult airway, defined as the presence of ≥2 predictors of difficult mask ventilation (DMV) based on Langeron et al., or a documented history of difficult intubation.
18 Years
ALL
No
Sponsors
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Mahidol University
OTHER
Responsible Party
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Locations
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Somdetphraphutthaloetla hospital
Samut Sakhon, , Thailand
Countries
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Central Contacts
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References
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Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011 May;106(5):617-31. doi: 10.1093/bja/aer058. Epub 2011 Mar 29.
Benham-Hermetz J, Mitchell V. Safe tracheal extubation after general anaesthesia. BJA Educ. 2021 Dec;21(12):446-454. doi: 10.1016/j.bjae.2021.07.003. Epub 2021 Aug 25. No abstract available.
Young CC, Harris EM, Vacchiano C, Bodnar S, Bukowy B, Elliott RRD, Migliarese J, Ragains C, Trethewey B, Woodward A, Gama de Abreu M, Girard M, Futier E, Mulier JP, Pelosi P, Sprung J. Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations. Br J Anaesth. 2019 Dec;123(6):898-913. doi: 10.1016/j.bja.2019.08.017. Epub 2019 Oct 3.
Blackwelder WC. "Proving the null hypothesis" in clinical trials. Control Clin Trials. 1982 Dec;3(4):345-53. doi: 10.1016/0197-2456(82)90024-1.
Langeron O, Masso E, Huraux C, Guggiari M, Bianchi A, Coriat P, Riou B. Prediction of difficult mask ventilation. Anesthesiology. 2000 May;92(5):1229-36. doi: 10.1097/00000542-200005000-00009.
Farrington CP, Manning G. Test statistics and sample size formulae for comparative binomial trials with null hypothesis of non-zero risk difference or non-unity relative risk. Stat Med. 1990 Dec;9(12):1447-54. doi: 10.1002/sim.4780091208.
Tung A, Fergusson NA, Ng N, Hu V, Dormuth C, Griesdale DGE. Pharmacological methods for reducing coughing on emergence from elective surgery after general anesthesia with endotracheal intubation: protocol for a systematic review of common medications and network meta-analysis. Syst Rev. 2019 Jan 24;8(1):32. doi: 10.1186/s13643-019-0947-2.
Minogue SC, Ralph J, Lampa MJ. Laryngotracheal topicalization with lidocaine before intubation decreases the incidence of coughing on emergence from general anesthesia. Anesth Analg. 2004 Oct;99(4):1253-1257. doi: 10.1213/01.ANE.0000132779.27085.52.
L'Hermite J, Wira O, Castelli C, de La Coussaye JE, Ripart J, Cuvillon P. Tracheal extubation with suction vs. positive pressure during emergence from general anaesthesia in adults: A randomised controlled trial. Anaesth Crit Care Pain Med. 2018 Apr;37(2):147-153. doi: 10.1016/j.accpm.2017.07.005. Epub 2017 Sep 4.
Radkowski P, Oniszczuk H, Opolska J, Pawluczuk M, Samiec M, Mieszkowski M. A Review of Non-Cardiac Complications of General Anesthesia: The Current State of Knowledge. Med Sci Monit. 2025 Apr 17;31:e947561. doi: 10.12659/MSM.947561.
Hartley M, Vaughan RS. Problems associated with tracheal extubation. Br J Anaesth. 1993 Oct;71(4):561-8. doi: 10.1093/bja/71.4.561. No abstract available.
Difficult Airway Society Extubation Guidelines Group; Popat M, Mitchell V, Dravid R, Patel A, Swampillai C, Higgs A. Difficult Airway Society Guidelines for the management of tracheal extubation. Anaesthesia. 2012 Mar;67(3):318-40. doi: 10.1111/j.1365-2044.2012.07075.x.
Other Identifiers
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Suction
Identifier Type: -
Identifier Source: org_study_id
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