The Effect of Endotracheal Tube Cuff Deflation at Different Train-of-Four Values on Bucking Against the Tube (TOF-BUCK)

November 11, 2026 updated by: Ahmet Gültekin, Namik Kemal University

The Effect of Endotracheal Tube Cuff Deflation at Different Train-of-Four Values on Involuntary Bucking Against the Tube: A Prospective, Randomized Controlled Study

This prospective, randomized controlled trial investigates the effect of deflating the endotracheal tube cuff at different Train of Four (TOF) recovery levels on the incidence of bucking (involuntary respiratory efforts and coughing against the tube) during emergence from general anesthesia. The study includes 60 patients scheduled for cholecystectomy procedures. Participants are randomly assigned to two distinct groups based on the predetermined TOF ratio at which their endotracheal tube cuff pressure is reduced prior to extubation. The primary objective is to determine if timing the cuff deflation according to objective neuromuscular monitoring minimizes airway complications and enhances overall patient safety and comfort. Secondary objectives include evaluating the effects of this intervention on hemodynamic stability and the incidence of postoperative nausea and vomiting.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

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

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients aged between 18 and 65 years
  • Patients scheduled for cholecystectomy surgery
  • Patients requiring tracheal intubation
  • Patients successfully intubated on the first attempt and in less than 30 seconds.
  • American Society of Anesthesiologists (ASA) physical status I or II.
  • General anesthesia duration of less than 3 hours.
  • Body Mass Index (BMI) < 30.

Exclusion Criteria:

  • Patients who refuse to participate in the study
  • Patients outside the specified age range
  • Patients presenting with signs of a difficult airway.
  • Patients with an increased risk of perioperative aspiration
  • American Society of Anesthesiologists (ASA) physical status III, IV, V, or VI.

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group 1: TOF Ratio > 0.9

In this group, the endotracheal tube cuff is deflated when the patient's Train-of-Four (TOF) ratio reaches > 0.9
Procedure: Endotracheal Tube Cuff Deflation

The procedure involves the deflation of the endotracheal tube cuff prior to extubation during emergence from general anesthesia.
Experimental: Group 2: TOF Ratio 0.75-0.85

In this group, the endotracheal tube cuff is deflated when the patient's Train-of-Four (TOF) ratio is between 0.75 and 0.85
Procedure: Endotracheal Tube Cuff Deflation

The procedure involves the deflation of the endotracheal tube cuff prior to extubation during emergence from general anesthesia.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of Bucking
Time Frame: From endotracheal tube cuff deflation up to 1 hour

The number of participants experiencing involuntary respiratory efforts, coughing, or bucking against the endotracheal tube during the emergence phase from general anesthesia.
From endotracheal tube cuff deflation up to 1 hour

Collaborators and Investigators

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

Sponsor

Namik Kemal University

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 (Estimated)

November 1, 2026

Primary Completion (Estimated)

May 1, 2027

Study Completion (Estimated)

June 1, 2027

Study Registration Dates

First Submitted

October 15, 2026

First Submitted That Met QC Criteria

November 11, 2026

First Posted (Actual)

November 12, 2026

Study Record Updates

Last Update Posted (Actual)

November 12, 2026

Last Update Submitted That Met QC Criteria

November 11, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2025.104.05.18

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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