PREMEDICATION  WITH MELATONIN AND MIDAZOLAM IN ELECTIVE SURGERIES UNDER GENERAL ANAESTHESIA – A CLINICAL COMPARATIVE STUDY.

Dr Preeti Loona; Hemalatha S.; Nalini K

Volume : V, Issue : II, February - 2016

PREMEDICATION WITH MELATONIN AND MIDAZOLAM IN ELECTIVE SURGERIES UNDER GENERAL ANAESTHESIA – A CLINICAL COMPARATIVE STUDY.

Dr Preeti Loona, Hemalatha S. , Nalini K

Abstract :

<p>&nbsp;Preoperative anxiety is as an unpleasant state of tension playing a critical role during intraoperative and postoperative events, may have adverse consequences extended hospital stay,delayed recovery and sleep disturbances. Benzodiazepines alleviate anxiety but may impair psychomotor performance, suppress the duration of rapid eye moment sleep. An alternative drug, melatonin (Nacetyl5methoxytryptamine) causes preoperative anxiolysis by exerting its hypnotic effects through activation of MT1 and MT2 melatonin receptors. METHODS: After approval from ethical committee, with simple random sampling technique,60 patients fulfilling the inclusion and exclusion criteria divided into two groups of 30 each as follows. Group A: received oral melatonin 6mg, night before surgery and 6mg, two hours before surgery. Group B: received oral midazolam 7.5mg , night before surgery and 7.5mg, two hours before surgery. VAS anxiety scores, VAS orientation score, sedation score, Digit symbol substitution test and Traeger dot test before and after giving the premedication, were studied. Induction dose of propofol and side effects,if any, also studied. RESULTS: 2 hrs after premedication , VAS anxiety scores with melatonin were 1.13&plusmn;1.22 whereas with midazolam it was 2.17&plusmn;.87 , hence p value was significant (&lt;0.0001), sedation scores for group A were 1.10&plusmn;.31 and group B 1.40&plusmn;.50 had significant p value of 0.0007. Also TDT and DSST were significant in Group A with p value of 0.04 for both tests. CONCLUSION: Anxiety was better relieved by melatonin . Midazolam provides better sedation but it impairs psychomotor functions which remains intact with melatonin.</p>