Yarimoglu Rafet, Basaran Betul, Et Tayfun, Bilge Aysegul, Korkusuz Muhammet
Department of Anesthesiology and Reanimation, Karaman Training and Research Hospital, Universite District. 1984 Street, Number:1, Karaman, Turkey.
Department of Anesthesiology and Reanimation, Karaman Training and Research Hospital, Karamanoglu Mehmetbey University, Karaman, Turkey.
BMC Anesthesiol. 2025 Mar 18;25(1):131. doi: 10.1186/s12871-025-03002-4.
Mask ventilation is the most widely used method to provide ventilation during anesthesia induction. Appropriate head and neck positions, exaggerated jaw lifts, two-hand and two-person ventilation, and the use of oral or nasal airways can facilitate mask ventilation. Neuromuscular blockers and premedication drugs such as midazolam and dexmedetomidine have also been proposed to facilitate mask ventilation. The hypothesis of this study was that midazolam premedication would facilitate mask ventilation in children.
Children aged 2-10 years were randomized into two groups. The midazolam group (Group M) received an intravenous dose of midazolam premedication (0.1 mg/kg, maximum dose 3 mg), and the control group received an intravenous dose of saline of the same volume (Group C). The primary outcome of the study was to examine the effect of midazolam premedication on mask ventilation in children, using the Han mask grading scale.
The data of 120 children were analyzed (n = 60 in Group M, n = 60 in Group C). According to the Han mask grading scale, the scores of the patients in the midazolam group were significantly lower than those of the control group. The distribution of Han scores was significantly different between the groups (p < 0.001). In the midazolam group, 93.3% of the children had a Han score of 1 and 6.7% had 2, and in the control group, 60% had a score of 1, and 40% had 2. In the subgroup analysis of overweight children, a Han score of 1 was determined in 91.7% of the midazolam group and 61.1% of the control group (p = 0.03).
In conclusion, the results of this clinical research demonstrated that midazolam premedication improves mask ventilation in children during general anesthesia induction. The findings also showed that the effect of midazolam in facilitating mask ventilation was similar in overweight children.
The study was registered in clinicaltrials.gov (trial ID: NCT05368441 on 10/05/2022).
面罩通气是麻醉诱导期间最广泛使用的通气方法。适当的头颈部位置、夸张的下颌抬起、双手双人通气以及使用口咽或鼻咽通气道可促进面罩通气。也有人提出使用神经肌肉阻滞剂和咪达唑仑、右美托咪定等术前用药来促进面罩通气。本研究的假设是咪达唑仑术前用药可促进儿童面罩通气。
将2至10岁的儿童随机分为两组。咪达唑仑组（M组）静脉注射咪达唑仑术前用药（0.1mg/kg，最大剂量3mg），对照组静脉注射相同体积的生理盐水（C组）。本研究的主要结局是使用韩氏面罩分级量表来检查咪达唑仑术前用药对儿童面罩通气的影响。
分析了120名儿童的数据（M组n = 60，C组n = 60）。根据韩氏面罩分级量表，咪达唑仑组患者的评分显著低于对照组。两组间韩氏评分分布有显著差异（p < 0.001）。在咪达唑仑组中，93.3%的儿童韩氏评分为1分，6.7%为2分；在对照组中，60%评分为1分，40%为2分。在超重儿童亚组分析中，咪达唑仑组91.7%的儿童韩氏评分为1分，对照组为61.1%（p = 0.03）。
总之，本临床研究结果表明，咪达唑仑术前用药可改善全身麻醉诱导期间儿童的面罩通气。研究结果还表明，咪达唑仑促进面罩通气的效果在超重儿童中相似。
本研究已在clinicaltrials.gov注册（试验编号：NCT05368441，于2022年5月10日注册）。
