The Effect of Midazolam on Remifentanil-Induced Difficulty in Mask Ventilation: A Randomised Study.

Objective: To explore the impact of midazolam premedication on the difficulty of mask ventilation induced by remifentanil during general anaesthesia induction.

Study design: A prospective, randomised, double-blind study. Place and Duration of the Study: This study was conducted at Karaman Training and Research Hospital, Karaman, Turkiye, from May 2022 to January 2024.

Methodology: This study included 120 patients aged 18-60 years with ASA score I-II scheduled to undergo general anaesthesia for elective surgery. The patients were randomly divided into two groups: Group M and Group C. Patients in Group M received midazolam premedication before induction, while patients in Group C received saline. After the general anaesthesia induction, the level of mask ventilation difficulty for the patients was evaluated using the Warters scale as a primary outcome of the study, in which an independent Sample t-test was used for comparison.

Results: The groups showed a significant difference in Warters scale results distribution (p <0.001). The mean Warters scores were 1.58 (2.03) in Group M and 3.40 (2.26) in Group C.

Conclusion: The study concluded that using midazolam premedication can help prevent difficulties with mask ventilation that may arise with the use of remifentanil during anaesthesia induction. The results also showed that midazolam premedication can facilitate mask ventilation for patients with risk factors for difficult mask ventilation.

Key words: Anaesthesia, General, Airway management, Midazolam, Opioids, Premedication, Remifentanil.