Endotracheal Tube Suctioning Versus No Suctioning During Emergence From General Anesthesia

January 9, 2026 updated by: Mahidol University

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

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.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

408

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Thailand
      • Samut Sakhon, Thailand, 75000
        • Recruiting
        • Somdetphraphutthaloetla hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: 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.
Procedure: 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.
Other Names:
  • SUC
Experimental: 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.
Procedure: Omission of Endotracheal Suctioning
Oropharyngeal suctioning only was performed prior to extubation. No suction catheter was inserted into the trachea.
Other Names:
  • NON-SUC

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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.
First 60 minutes after extubation

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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.
First 60 minutes after extubation
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.
First 60 minutes after extubation
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.
First 60 minutes after extubation
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.
First 60 minutes after extubation
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.
At 24 hours after surgery (± 2 hours)
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.
From arrival in the PACU until discharge from the PACU, assessed up to 6 hours after PACU arrival.

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
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.
From arrival in the PACU until discharge from the PACU, assessed up to 6 hours after PACU arrival.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Mahidol University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 5, 2026

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

March 31, 2027

Study Registration Dates

First Submitted

November 15, 2025

First Submitted That Met QC Criteria

December 16, 2025

First Posted (Estimated)

December 17, 2025

Study Record Updates

Last Update Posted (Estimated)

January 12, 2026

Last Update Submitted That Met QC Criteria

January 9, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Suction

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because the ethics committee approval and institutional data governance policies do not allow external sharing of identifiable or de-identified participant-level data. Access to study data is restricted to the research team to protect participant confidentiality and comply with local regulatory requirements.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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