This study is a randomized controlled trial. Adult patients undergoing thyroidectomy under general anesthesia at Severance Hospital and Yonsei Cancer Center are included in tis study. For intervention group, patients receive anesthesia with total intravenous remimazolam, while for control group, patients receive anesthesia with inhalation anesthetic.

The primary end point of the study is to determine whether coughing during endotracheal tube extubation is less when anesthesia is maintained with intravenous remimazolam compared to inhalation anesthetics. The secondary end points are cough score (graded into 4 levels), frequency of reoperation due to postoperative bleeding, These include the frequency of hypertension during the extubation process and whether additional painkillers are used in the recovery room.

Inclusion Criteria:

Adult patients aged 19 years or older undergoing thyroidectomy under general anesthesia at Severance Hospital Cancer Center.

Exclusion Criteria:

• Patients with American society of anesthesiologists physical status classification IV or higher.
• Patients who are hypersensitive to remimazolam or inhalational anesthetic.
• Patients with structural abnormalities in the upper airway or respiratory diseases.
• Patients with a history of upper respiratory tract infection within the past 2 weeks.
• Current smoker
• Pregnant
• Patients who have difficulty reading and understanding the informed consent form