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Can Nasopharyngeal Suction Under Anesthesia Reduce the Incidence of Respiratory Adverse Events After Supraglottic

Namitha Mariam Lal1, Priyankar Kumar Datta2, Renu Sinha3

  • 1Resident Doctor, Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.

AANA Journal
|July 23, 2026
PubMed

Insights

Nasopharyngeal suctioning did not reduce respiratory adverse events in all children after airway device removal. However, it significantly lowered these events in children with recent or active upper respiratory infections.

Area of Science:

  • Pediatric Anesthesiology
  • Respiratory Medicine

Background:

  • Perioperative respiratory adverse events (PRAE) are common after airway device removal in children.
  • Supraglottic airway (SGA) devices are frequently used in pediatric anesthesia.
  • Effective strategies to minimize PRAE are crucial for patient safety.

Purpose of the Study:

  • To investigate the efficacy of nasopharyngeal suction in reducing PRAE following SGA removal in pediatric patients.
  • To assess the impact of nasopharyngeal suction in children with and without upper respiratory tract infections (URTI).

Main Methods:

  • A randomized controlled trial involving 400 children (ages 1-6 years) undergoing general anesthesia with SGA.
  • Patients were randomized to receive either combined nasopharyngeal and oral suction (Group N) or oral suction alone (Group O) prior to SGA removal.
  • PRAE, including coughing, breath-holding, airway obstruction, laryngospasm, bronchospasm, and desaturation, were monitored.

Main Results:

  • The overall incidence of PRAE was 21.8% with no significant difference between Group N (21.2%) and Group O (22.3%).
  • In a subgroup of children with active or recent URTI, Group N showed a significantly lower incidence of PRAE (21.7%) compared to Group O (44.7%).
  • The relative risk for PRAE in the URTI subgroup was 0.486 (95% CI, 0.258 to 0.917; P = .019), with a number needed to treat of 4.4.

Conclusions:

  • Nasopharyngeal suctioning prior to SGA removal does not reduce the overall incidence of PRAE in the general pediatric population.
  • Nasopharyngeal suctioning significantly reduces the incidence of PRAE in pediatric patients with active or recent upper respiratory tract infections.
  • Targeted nasopharyngeal suctioning may be a beneficial intervention for specific pediatric populations at higher risk for respiratory complications.

Keywords:
pediatric airwayperioperative respiratory adverse eventssuctioningsupraglottic device

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