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HypoxiaNCT07287293

Endotracheal Tube Suctioning Versus No Suctioning During Emergence From General Anesthesia

A study testing Routine Endotracheal Suctioning and Omission of Endotracheal Suctioning in people with Hypoxia and Airway Obstruction, Postoperative, run by Mahidol University at 1 site in Thailand.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

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)… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Routine Endotracheal Suctioning and Omission of Endotracheal Suctioning
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
408 participants
Where
1 siteThailand
Study dates
5 Jan 2026to 31 Mar 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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.

Who cannot join

  • 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.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Saowaluk Sotananan, Doctor of Medicine contact

+66894549111

pum.sotananan@gmail.com

Thailand1 site, 1 recruiting
  • Somdetphraphutthaloetla hospital

    Samut Sakhon, 75000

    Recruiting

Other trials in Thailand

About this study

Official title: 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:

Read more
  • 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.

Being tested
Routine Endotracheal Suctioning, Omission of Endotracheal Suctioning
Keywords
Airway Management, Suctioning, Emergence from Anesthesia, Hypoxia, Endotracheal Intubation, Postoperative Complications
Medical subject headings
Hypoxia, Airway Obstruction, Pharyngitis, Cough, Postoperative Complications

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Routine Endotracheal SuctioningProcedure or surgery

    Also called SUC

    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 SuctioningProcedure or surgery

    Also called NON-SUC

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

Study groups in NCT07287293
Study groupRoleWhat they receive
Routine Endotracheal Suctioning (SUC)Active comparatorParticipants 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.
Receives: Procedure: Routine Endotracheal Suctioning
Omission of Endotracheal Suctioning (NON-SUC)ExperimentalParticipants 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.
Receives: Procedure: Omission of Endotracheal Suctioning

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of postoperative desaturation 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.

    Measured: First 60 minutes after extubation

Secondary outcomes (6)
  1. Incidence and severity of postoperative coughing

    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.

    Measured: First 60 minutes after extubation

  2. Severity of sore throat during swallowing

    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.

    Measured: First 60 minutes after extubation

  3. Requirement and level of oxygen therapy

    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.

    Measured: First 60 minutes after extubation

  4. Incidence of postoperative nausea and vomiting

    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.

    Measured: First 60 minutes after extubation

  5. Patient satisfaction

    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.

    Measured: At 24 hours after surgery (± 2 hours)

  6. Incidence of extubation-related adverse events

    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.

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

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Dec 2025
  2. Study start5 Jan 2026
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Mar 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
Interventions 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.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
408 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07287293
Sponsor's protocol ID
Suction
Status last verified
Jan 2026
First submitted
15 Nov 2025
Last updated
12 Jan 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: 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.

Publications

  • 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.

    PubMed 31587835
  • 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.

    PubMed 7160191
  • 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.

    PubMed 10781266
  • 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.

    PubMed 2281232
  • 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.

    PubMed 30678727
  • 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.

    PubMed 15385385
  • 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.

    PubMed 28882741
  • 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.

    PubMed 40241288
  • 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.

    PubMed 8260307
  • 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.

    PubMed 22321104
  • 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.

    PubMed 34840816
  • 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.

    PubMed 21447488

Questions about this trial

What is this clinical trial studying?

A study testing Routine Endotracheal Suctioning and Omission of Endotracheal Suctioning in people with Hypoxia and Airway Obstruction, Postoperative, run by Mahidol University at 1 site in Thailand.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 12 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Thailand. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Saowaluk Sotananan, Doctor of Medicine (+66894549111, pum.sotananan@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of postoperative desaturation after extubation (time frame: First 60 minutes after extubation). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07287293, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jan 2026; AzTrials last refreshed its copy on 7 Nov 2026.

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