INTRODUCTION: During laryngoscopy and intubation there is an increase in both heart rate and blood pressure due to sympathetic response mediated by catecholamines and activation of tracheal nociceptors due to its manipulation. Melatonin has been used for sleep regulation and ICU sedation but there are very few studies to evaluate its effect on reducing haemodynamic stress response during laryngoscopy and intubation. In our study we evaluated the effects of melatonin in reducing the haemodynamic changes during laryngoscopy and intubation. : 100 patients belonging to ASA grade 1 and 2 of either gender METHODOLOGY , of age 18 to 60 years who were planned for elective surgery under general anaesthesia were randomly divided into two groups: Group M (n=50) was given 6 mg oral melatonin (two capsules of 3 mg each) and Group C (n=50) was given multivitamin capsules with a sip of water 90 minutes before induction of anaesthesia. General anaesthesia was induced using standard method for both the groups and changes in heart rate and blood pressure were noted in pre operative period, during intubation and at 1, 3, 5 and 10 min after intubation. The me RESULTS: an pulse rate was comparable between the two groups at baseline. During intubation heart rate was increased in both groups but rise was signicant in control group which persisted upto10 minutes, while in melatonin group it started settling within 3 minutes. There was a signicant rise in SBP, DBP and MAP in control group during and after intubation till 5 minutes as compared to melatonin group. Oral melat CONCLUSION: onin can be used in pre operative period to effectively reduce the hemodynamic stress response during and after laryngoscopy and intubation.
Introduction: Postoperative pain is one of the major causes of dissatisfaction and prolonged hospital stay in patients undergoing surgery under general anaesthesia. Melatonin has been used for sleep regulation and Intensive Care Unit (ICU) sedation but there is limited knowledge regarding its effect postoperative analgesia and sedation. Aim: To evaluate the effects of preoperative melatonin on postoperative sedation and analgesia. Materials and Methods: This randomised controlled study was conducted from June 2020 to June 2021, at Mahatma Gandhi Memorial Medical College and M.Y. Hospital, Indore, Madhya Pradesh, India. Total 100 patients belonging to American Society of Anesthesiologists (ASA) grade I and II of either gender, of age 18 to 60 years who were planned for elective surgery under general anaesthesia were randomly divided into two groups. Group M (n=50) was given 6 mg oral melatonin (two capsules of 3 mg each), and group C (n=50) was given multivitamin capsules, 90 minutes before induction of anaesthesia. General anaesthesia was induced using standard method for both the groups. Sedation score was assessed in preoperative period as well as after giving drugs and till 4 hours postoperatively by using Ramsay Sedation score. Pain was evaluated by Visual Analogue Scale (VAS) score till 8 hours postoperatively. Time of request of first rescue analgesia was noted and compared to that of control group. Results: At preoperative time sedation score was comparable between both the groups. At postoperative time, sedation score 4 was seen in significantly higher number of patients of group M in comparison to group C, while at all the other time intervals, sedation scores were comparable between the two groups. Mean VAS score was found to be significantly higher in group C (3.2±0.4) in comparison to group M (3.02±0.14), 4 hours postoperatively. The mean time to request for first rescue analgesia in group M was 7.27±1.01 hours and in group C was 5.40±0.78 hour (p-value=0.001). Conclusion: Preoperative oral melatonin can be used to effectively reduce the postoperative pain without producing undue sedation.
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