Melatonin Provides Anxiolysis, Enhances Analgesia, Decreases Intraocular Pressure, and Promotes Better Operating Conditions During Cataract Surgery Under Topical Anesthesia

Ismail, Salah A.; Mowafi, Hany A.

doi:10.1213/ane.0b013e3181907ebe

Cited by 138 publications

(135 citation statements)

References 24 publications

Supporting

Mentioning

120

Contrasting

Unclassified

Order By: Relevance

“…Several studies have used VAS to analyze pre-surgery anxiety. Findings have shown that average VAS values range between 40 and 50 for a cataract operation under topical anesthesia (8,15) and between 50 and 60 prior to other surgical procedures (9,16), whereas moderate or severe anxiety was found in 65.5% of women prior to a cesarean section (17). These values are higher than those found in our study.…”

Section: Main Endoscopic Diagnosis Principal (N %)contrasting

confidence: 77%

“…Some are also used in the case of colonoscopy (4,5,8,9). Therefore, if the state of anxiety is clinically significant it is possible to resort to such methods to improve the situation All the above circumstances justify the need to carry out the study, with the objective of analyzing the frequency and degree of outpatient colonoscopy anxiety in our hospital, as well as determining the factors which cause this effect, and its influence on the tolerance of the procedure.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prospective study of anxiety in patients undergoing an outpatient colonoscopy

Bensusán¹,

Martín²,

Álvarez³

2016

Rev Esp Enferm Dig

View full text Add to dashboard Cite

Background: Undergoing a colonoscopy can cause anxiety in patients and this is something which has not been closely studied.Objective: To determine the frequency and intensity of anxiety prior to a colonoscopy and the factors which are related to the procedure.Methods: This is a prospective study of patients undergoing outpatient colonoscopy in our hospital. Anxiety was assessed using a visual analogue scale of 0 to 100. The severity of anxiety was rated as mild (1-29), moderate (30-79) or severe (80-100).Results: Three hundred and twenty-seven patients completed the study, of whom 154 (47.1%) were men with a median age of 54 years (p25-75: 45-65). Three hundred and nine (94.5%) patients were found to suffer a certain degree of anxiety. The median value on the visual analogue scale was 31 (p25-75: 10-53). Anxiety levels were mild in 136 patients (44%), moderate in 141 (45.6%) and severe in 32 (10.4%). Greater anxiety was associated with female patients (mean 40.38 vs 31.99, p = 0.01) and a poorly tolerated previous colonoscopy (mean 50.67 vs 28.44, p = 0.01) and correlated inversely with age (r = -0.170, p = 0.02).Conclusions: Colonoscopy causes some degree of anxiety in most patients. Being female, younger and having experienced poor tolerance to a previous scan are associated with greater degrees of anxiety. These findings should be taken into account in the implementation of measures to improve the quality and tolerance of colonoscopy.

show abstract

Section: Main Endoscopic Diagnosis Principal (N %)contrasting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Prospective study of anxiety in patients undergoing an outpatient colonoscopy

Bensusán¹,

Martín²,

Álvarez³

2016

Rev Esp Enferm Dig

View full text Add to dashboard Cite

show abstract

“…Because melatonin reduces IOP in experimental models, it would be of interest to see whether this effect is also feasible in humans. In this sense, some ophthalmologists have started to use melatonin to reduce IOP in patients undergoing cataract surgery, indicating the relevance of this molecule as regulator of IOP (Ismail and Mowafi, 2009), suggesting its possible use as a treatment of ocular hypertension.…”

Section: Introductionmentioning

confidence: 99%

Melatonin Receptors Trigger cAMP Production and Inhibit Chloride Movements in Nonpigmented Ciliary Epithelial Cells

Huete-Toral

Crooke

Martínez-Águila

et al. 2014

J Pharmacol Exp Ther

View full text Add to dashboard Cite

Melatonin and its analog 5-MCA-NAT (5-methylcarboxyamino-N-acetyl tryptamine) are active compounds reducing intraocular pressure (IOP). This action is mediated through MT 2 and the putative MT 3 melatonin receptor, producing a transient reduction of IOP that lasts for a few hours and has not yet been characterized. The use of melatonin and its analog are causing a decrease in chloride efflux from rabbit nonpigmented epithelial cells (NPE), possibly explaining the decrease in IOP. Melatonin and 5-MCA-NAT inhibited rabbit NPE chloride release in a concentration-dependent manner, whereas the pD 2 values were between 4.5 6 1.2 and 4.4 6 1.0, respectively. Melatonin hypotensive action was enhanced by the presence of MT 2 antagonists, such as DH97 (N-pentanoyl-2-benzyltryptamine) and 4-P-P-DOT (4-phenyl-2-propionamidotetralin) and by the nonselective melatonin receptor antagonist luzindole. Prazosin (1.5 mM) partially reverses the melatonin action by acting as a selective MT 3 antagonist. However, at 15 nM it acts as an a-adrenergic receptor antagonist, enhancing the melatonin effect. Regarding the intracellular pathways triggered by melatonin receptors, neither phospholipase C/protein kinase C pathway nor the canonical reduction of intracellular cAMP was responsible for melatonin or 5-MCA-NAT actions. On the contrary, the application of these substances produced a concentration-dependent increase of cAMP, with pD 2 values of 4.6 6 0.2 and 4.9 6 0.7 for melatonin and 5-MCA-NAT, respectively. In summary, melatonin reduces the release of chloride concomitantly to cAMP generation. The reduction of Cl 2 secretion accounts for a decrease in the water outflow and therefore a decrease in aqueous humor production. This could be one of the main mechanisms responsible for the reduction of IOP after application of melatonin and 5-MCA-NAT.

show abstract

“…There are several ways for drugs to reach the ocular system, for instance, melatonin orally administered at a concentration of 10 mg to patients before performing cataract surgery have shown to lower intraocular pressure, consequently, they had better operating condition [20]. Melatonin was also investigated for the treatment of uveitis in hamsters, experiments were done by injecting 5 mg of melatonin before the induction of uveitis, and results suggested that melatonin prevents the clinical and biochemical consequences of this disorder [21].…”

Section: Short Commentarymentioning

confidence: 99%