Study Comparing Two Methods of Removing Breathing Tubes in Children Under General Anaesthesia to Reduce Breathing Problems After Surgery

What this Trial Is About

Researchers are evaluating two different techniques for removing an endotracheal tube ETT in children after surgery under general anaesthesia. The study compares awake removal of ETT versus deep removal of ETT followed by insertion of a laryngeal mask airway LMA, which is then removed when the child is awake. The goal is to see if the LMA exchange method reduces the occurrence of postoperative respiratory problems, such as coughing, airway obstruction, or desaturation, and to assess other outcomes like pain, delirium, and nausea. During surgery, anaesthesia is managed by the attending anaesthetist according to usual care. Children undergoing surgery with ETT will be assigned by week to either awake ETT removal or deep ETT removal with LMA exchange. For the LMA exchange group, the ETT is removed under deep anaesthesia and replaced with an LMA, which is then removed once the child is awake in the post-anaesthetic care unit PACU. The study cycles between these two methods in four-week blocks until enough participants are included. Participants will be monitored from the time of extubation until discharge from PACU. Data collected includes respiratory adverse events, airway interventions, pain and delirium scores, opioid use, timing of recovery milestones, nausea and vomiting rates, and throat symptoms after surgery. Demographic and clinical information will also be recorded. The study aims to provide detailed comparisons of respiratory safety and recovery between the two extubation methods in children up to 16 years old.

BELUGA: Better to Exchange ETT for LMA Before Extubation in Children Under General Anaesthesia