Median effective dose of remimazolam combined with sufentanil for inhibiting laryngeal mask airway insertion responses in children of different ages.

Introduction: We determined the median effective dose and 95% confidence interval (CI) of remimazolam required to inhibit laryngeal mask airway (LMA) insertion reactions combined with sufentanil 0.3 μg/kg in pediatric anesthesia. Methods: Children scheduled to undergo elective laryngeal mask anesthesia were divided into the preschool (age: 3-6 years) and school-age (6-12 years) groups. The timer was started after intravenous remimazolam was administered; thereafter, 0.3 μg/kg sufentanil was injected intravenously. The laryngeal mask was placed 3 min after remimazolam was finished. If a positive response to LMA insertion, such as movement, swallowing, coughing, hiccups, or other reactions, was observed during the insertion, the dose was increased by 0.03 mg/kg for the next patient; if there was no response, the dose was decreased by 0.03 mg/kg instead. The trial officially commenced after the first LMA was successfully inserted and continued until alternating positive and negative responses formed seven crossover points. Thereafter, probit regression was performed to calculate the median effective dose (ED Results: Overall, 52 children were included; 25 belonged to the preschool group and 27 to the school-age group. In the preschool group, the ED Conclusion: Remimazolam can be safely used for laryngeal mask anesthesia induction in pediatric patients. Clinical Trial Registration: https://www.chictr.org.cn/, identifier ChiCTR2400087333.