Midazolam co‐induction and laryngeal mask insertion

We have studied the effect of alfentanil and midazolam + alfentanil on the conditions for laryngeal mask airway insertion in patients receiving propofol for induction of anaesthesia. Ninety unpremedicated, ASA 1 or 2 adult patients were randomly allocated to one of three groups: group P received propofol only (2.5 mg.kg‐1); group PA received alfentanil (10 μg.kg‐1) followed by propofol (1.25 mg.kg‐1); group PMA received midazolam (0.04 mg.kg‐1) and alfentanil (10 μg.kg‐1) followed by propofol (1.25 mg.kg ‐1). Further boluses of propofol (0.25 mg.kg ‐1 every 15 s) were given if the initial dose was inadequate for induction of anaesthesia. Patients in the midazolam + alfentanil group required less propofol (p < 0.001), had better mouth opening (p < 0.001) and fewer undesired responses to laryngeal mask airway insertion (p < 0.001) than the other two groups.

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