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

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.