Premedication effect of melatonin on propofol induction dose for anesthesia, anxiety, orientation and sedation after abdominal surgery: a double-blinded randomized trial

Abstract

The present study addressed the effect of melatonin premedication on propofol induction dose for anesthesia in abdominal surgery. This is a double-blinded clinical trial in which abdominal surgery patients admitted to the Valiasr Hospital, Iran ( n = 88) were enrolled and individually randomized into two groups: melatonin and placebo groups sublingually administered 3 mg of melatonin and placebo, respectively, 50 minutes before surgery. Their anxiety, orientation, and sedation were recorded before melatonin administration, anesthesia induction, and recovery, while we also recorded the propofol induction dose required for general anesthesia. Anxiety was seen less in the melatonin group than the placebo group ( P < 0.05), whereas orientation was significantly different before anesthesia induction ( P = 0.044) and sedation was the same before the induction ( P = 0.044) and recovery ( P = 0.049) in both groups, with a better efficiency in the melatonin group in which a lower dose of propofol was used ( P = 0.002). The sedation, anxiety, and propofol dose used were lower in the melatonin group than the placebo group. The recommended dosage was 3 mg of melatonin once to achieve an anesthetic depth index or a bispectral index of 40. The study was approved by Ethical Committee of Arak University of Medical Sciences with IR.ARAKMU.REC.1395.432 code in July 2016, and the trial was registered in Iranian Registry of Clinical Trials with IRCT20141209020258N98 in September 2016.

The pain control efficacy of zolpidem versus melatonin after intervertebral disc herniation surgery under general anaesthesia: A randomised clinical trial

“…A comparative clinical trial on the efficacy of melatonin premedication on propofol induction dose, as well as postoperative anxiety and sedation in abdominal surgery, reported that propofol dose administrated was lower in the melatonin group than the placebo group, whereas the melatonin group had higher anxiety and less sedation. [ 13 ] Similarly, superior analgesia and sedation in the melatonin arm were supported by our trial.…”

“…Because the use of analgesic premedication helps minimise the need for opioids intraoperatively,[ 12 13 14 ] a multiple-dose regimen of melatonin premedication can cause sedation and analgesia, and not cognitive impairment, psychomotor skills, and prolonged recovery time. [ 12 13 ] It could reduce anxiety and pain compared with placebo, as corroborated by some evidence, including a systematic review (2014) of 24 clinical trials with 1749 participants in which three trials addressed the reliable anaesthetic induction dose. Their bottom line was that melatonin was capable to afford a reduced anaesthetic requirement, but with no effect on that of sevoflurane.…”

Serum melatonin is inversely associated with matrix metalloproteinase‑9 in oral squamous cell carcinoma

“…Previous studies have reported a modest reduction in melatonin secretion on the first day following different types of surgery, such as orthopedic and abdominal, compared with pre-surgery levels, as well as a high increase in melatonin secretion on the second day following surgery (29,30). The decrease in melatonin and MMP-9 serum level one day post-surgery may be due to the effects of general anesthesia, particularly the administration of propofol (31,32). To eliminate the influence of propofol on the circadian rhythm of melatonin and MMP-9 in patients with OSCC in the present study, blood was collected on the second day post-surgery.…”

Adjuvant effect of melatonin premedication on propofol induction dose

“…Like this study Turkistani et al, (8) found that melatonin premedication, in an oral dose of either 3 or 5 mg reduced the required dose of propofol to achieve BIS score of 45. Also, Norouzi et al, (9) did their study on 100 patients had abdominal surgery by dividing them into two groups melatonin 3mg who received melatonin 3mg 50 min before surgery and placebo group and reveal that propofol dose used was lower in the melatonin group than the placebo group.…”