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NCT Number: NCT07287293

Endotracheal Tube Suctioning Versus No Suctioning During Emergence From General Anesthesia

The goal of this study is to determine whether omitting tracheal suctioning immediately prior to extubation is non-inferior to routine tracheal suctioning with respect to early postoperative oxygenation among adult surgical patients (aged 18-90 years, American Society of Anesthesiologists [ASA] physical status I-III) undergoing elective surgery under general anesthesia with endotracheal intubation.

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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Key information

Conditions

Hypoxia Airway Obstruction Airway Obstruction, Postoperative Cough Cough, Postoperative Infections Otorhinolaryngologic Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Pharyngeal Diseases Pharyngitis Postoperative Complications Respiration Disorders Respiratory Insufficiency Respiratory Tract Diseases Respiratory Tract Infections Signs and Symptoms Signs and Symptoms, Respiratory Sore Throat Stomatognathic Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Somdetphraphutthaloetla hospital

Samut Sakhon, 75000, Thailand

Location status: Recruiting

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adults aged 18-90 years with American Society of Anesthesiologists (ASA) physical status I-III.
  • Scheduled for elective surgery under general anesthesia requiring endotracheal intubation.
  • Planned tracheal extubation in the operating room at the end of surgery.

Exclusion criteria

  • Inability to provide informed consent or the presence of a significant language barrier that prevents effective communication with the clinical team.
  • 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.

Treatment and study plan

Routine Endotracheal Suctioning

Procedure

Endotracheal suctioning performed immediately prior to extubation using standard suction pressure and technique. Oropharyngeal suctioning was also performed according to routine clinical practice.

Other names: SUC

Omission of Endotracheal Suctioning

Procedure

Oropharyngeal suctioning only was performed prior to extubation. No suction catheter was inserted into the trachea.

Other names: NON-SUC

Primary outcomes

  1. Incidence of postoperative desaturation after extubation

    Time frame: First 60 minutes after extubation

    Proportion of participants who develop desaturation, defined as peripheral oxygen saturation (SpO₂) <92% at any time within the first 60 minutes after extubation.

Secondary outcomes

  1. Incidence and severity of postoperative coughing

    Time frame: First 60 minutes after extubation

    Incidence and severity of postoperative coughing within the first 60 minutes after extubation, assessed using the modified Minogue scale. Severity is recorded as the highest coughing score observed during the assessment period.

  2. Severity of sore throat during swallowing

    Time frame: First 60 minutes after extubation

    Severity of sore throat during swallowing within the first 60 minutes after extubation, assessed using a 0-10 numerical rating scale (NRS). The outcome is recorded as the highest score reported during the assessment period.

  3. Requirement and level of oxygen therapy

    Time frame: First 60 minutes after extubation

    Requirement for oxygen therapy and the highest level of escalation within the first 60 minutes after extubation, including nasal cannula, simple face mask, reservoir mask, or more advanced oxygen delivery devices as clinically indicated.

  4. Incidence of postoperative nausea and vomiting

    Time frame: First 60 minutes after extubation

    Incidence of postoperative nausea and vomiting occurring within the first 60 minutes after extubation. Nausea and vomiting are recorded as present or absent during the assessment period.

  5. Patient satisfaction

    Time frame: At 24 hours after surgery (± 2 hours)

    Patient satisfaction with anesthetic care at 24 hours after surgery, assessed using a 0-10 numerical rating scale (NRS), where 0 indicates complete dissatisfaction and 10 indicates complete satisfaction. The recorded value represents the patient's reported score at the 24-hour assessment.

  6. Incidence of extubation-related adverse events

    Time frame: From arrival in the PACU until discharge from the PACU, assessed up to 6 hours after PACU arrival.

    Incidence of extubation-related adverse events during the post-anesthesia care unit (PACU) stay, including bronchospasm, laryngospasm, reintubation, and post-obstructive pulmonary edema. Events are recorded as present or absent throughout the PACU monitoring period. The PACU stay typically lasts 2-3 hours depending on discharge criteria.

Other outcomes

  1. Duration of stay in the post-anesthesia care unit (PACU)

    Time frame: From arrival in the PACU until discharge from the PACU, assessed up to 6 hours after PACU arrival.

    Total duration of stay in the post-anesthesia care unit (PACU), recorded in minutes from arrival in PACU until discharge based on standard discharge criteria. The PACU stay typically lasts 2-3 hours depending on discharge criteria.

Study contacts

Contact information is provided by the study sponsor or research team.

Saowaluk Sotananan, Doctor of Medicine

CONTACT

[email protected]

+66894549111

Sponsors and collaborators

Lead sponsor

Mahidol University

Other

Registry information

Official study title

Comparison of Endotracheal Tube Suctioning Versus No Suctioning During Emergence From General Anesthesia With Endotracheal Intubation: A Randomized, Single-Blind Study

Important dates

Study start
2026
Primary completion
2026
Study completion
2027
First posted
Dec 17, 2025
Registry last updated
Jan 12, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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