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Perioperative effects of melatonin and midazolam premedication on sedation, orientation, anxiety scores and psychomotor performance

  • M. Acil (a1), E. Basgul (a1), V. Celiker (a1), A. H. Karagöz (a1), B. Demir (a1) and U. Aypar (a1)...

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Summary

Background and objective: To compare the perioperative effects of melatonin and midazolam given in premedication, on sedation, orientation, anxiety scores and psychomotor performance.

Methods: Exogenous administration of melatonin not only facilitates the onset of sleep but also improves its quality. A prospective, randomized, double-blind, placebo-controlled study was performed in 66 patients undergoing laparoscopic cholecystectomy. Patients were given melatonin 5 mg, midazolam 15 mg or placebo, 90 min before anaesthesia, sublingually. Sedation, orientation and anxiety were quantified before; 10, 30, 60 and 90 min after premedication; and 15, 30, 60 and 90 min after admission to the recovery room. Neurocognitive performance was evaluated at these times, using the Trail Making A and B and Word Fluency tests. The differences between the groups were analysed by ANOVA. Two-way comparisons were performed by Scheffé analysis. Sedation and amnesia were analysed by the χ2 test.

Results: Patients who received premedication with either melatonin or midazolam had a significant increase in sedation and decrease in anxiety before operation compared with controls. After operation, there was no difference in sedation scores of all groups. Whereas, 30, 60 and 90 min after premedication the melatonin and midazolam groups exhibited a significantly poorer performance in Trail Making A and B tests compared with placebo, there were no significant differences among the groups in terms of neuropsychological performance after the operation. Amnesia was notable only in the midazolam group for one preoperative event.

Conclusion: Melatonin premedication was associated with preoperative anxiolysis and sedation without postoperative impairment of psychomotor performance.

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Corresponding author

Correspondence to: Ayşe Heves Karagöz, Department of Anaesthesiology and Reanimation, Faculty of Medicine, Hacettepe University, Sıhhıye Ankara 06100, Turkey. E.mail: heves@ada.net.tr; Tel: +90 312 3051207; Fax: +90 312 3109600

References

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References

Wetterberg L. Melatonin and clinical application. Reprod Nutr Dev 1999; 39: 367382.
Lissoni P, Barni S, Crispino S, Tancini G, Fraschini F. Endocrine and immune effects of melatonin therapy in metastatic cancer patients. Eur J Cancer Clin Oncol 1989; 25: 789795.
Pierpaoli W, Maestroni GJ. Melatonin: a principal neuroimmunoregulatory and anti-stress hormone: its anti-aging effects. Immunol Lett 1987; 16: 355361.
Cramer H, Rudolph J, Consbruch U, Kendel K. On the effects of melatonin on sleep and behavior in man. Adv Biochem Psychopharmacol 1974; 11: 187191.
Wurtman RJ, Zhdanova I. Improvement of sleep quality by melatonin. Lancet 1995; 346: 1491.
Naguib M, Samarkandi AH. Premedication with melatonin: a double blind, placebo-controlled comparison with midazolam. Br J Anaesth 1999; 82: 875880.
Naguib M, Samarkandi AH. The comparative dose–response effects of melatonin and midazolam for premedication of adult patients: a double-blinded, placebo-controlled study. Anesth Analg 2000; 91: 473479.
Shafer A, White PF, Urquhart ML, Doze VA. Outpatient premedication: use of midazolam and opioid analgesics. Anesthesiology 1989; 71: 495501.
Dawson D, Encel N. Melatonin and sleep in humans. J Pineal Res 1993; 15: 112.
Kontinen VK, Maunuksela EL, Sarvela J. Premedication with sublingual triazolam compared with oral diazepam. Can J Anesth 1993;40: 829834.
Cella DF, Perry SW. Reliability and concurrent validity of three visual-analogue mood scales. Psychol Rep 1986; 59: 827833.
Luria RE. The validity and reliability of the visual analogue mood scale. J Psychiatr Res 1975; 12: 5157.
Spreen O, Strauss E. A Compendium of Neuropsychological Tests: Administration, Norms and Commentary.Oxford, UK: University Press, 1991: 320331.
Reitan RM. Validity of the Trail Making Test as an indication of organic brain damage. Perceptual and Motor Skill 1958; 8: 271276.
Benton AL, Hamsher K. Multilingual Aphasia Examination: Manual of Instructions.Iowa City, USA: AJA Associates, 1983.
Slotten HA, Krekling S. Does melatonin have an effect on cognitive performance? Psychoneuroendocrinology 1996; 21: 673680.
Lieberman HR, Waldhauser F, Garfield G, Lynch HJ, Wurtman RJ. Effects of melatonin on human mood and performance. Brain Res 1984; 323: 201207.
Richardson MG, Wu CL, Hussain A. Midazolam premedication increases sedation but does not prolong discharge times after brief outpatient general anesthesia for laparoscopic tubal sterilization. Anesth Analg 1997; 85: 301305.

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