Midazolam co‐induction and laryngeal mask insertion

Summary 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.