Comparison of effects of oral melatonin with oral alprazolam used as a premedicant in adult patients undergoing various surgical procedures under general anesthesia: A prospective randomized placebo-controlled study

Khare, Arvind; Thada, Beena; Jain, Neena; Singh, Deepak; Singh, Maina; Sethi, Surendra Kumar

doi:10.4103/aer.aer_90_18

Cited by 9 publications

(8 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The results of studies by Khare et al [14] and Lotfy and Ayaad [15] align with that of the current study. Khare et al discovered that premedication with oral melatonin (6 mg) serves as an effective alternative to alprazolam, offering improved anxiolysis, less sedation, and maintenance of cognitive and psychomotor function [14]. Furthermore, a systemic literature review by Campbell et al revealed that perioperative melatonin, administered in daily doses of 2-8 mg for one to nine days, starting on the evening before or the day of surgery, reduced the incidence of postoperative complications such as anxiety and delirium following major surgeries [16].…”

Section: Discussionsupporting

confidence: 92%

“…Our findings regarding the analgesic effect of melatonin align with earlier studies, further supporting the efficacy of melatonin as a premedication agent [ 3 , 9 , 11 - 13 ]. The results of studies by Khare et al [ 14 ] and Lotfy and Ayaad [ 15 ] align with that of the current study. Khare et al discovered that premedication with oral melatonin (6 mg) serves as an effective alternative to alprazolam, offering improved anxiolysis, less sedation, and maintenance of cognitive and psychomotor function [ 14 ].…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Assessing the Premedication Properties of Sublingual Melatonin in Young Women Undergoing Cesarean Section With Spinal Anesthesia: A Double-Blind Randomized Study

Alkhfaji,

Hussein,

Mutar

et al. 2024

Cureus

View full text Add to dashboard Cite

Introduction: Preoperative anxiety can negatively impact patient outcomes by influencing the intraoperative requirements for anesthetics and analgesics, increasing postoperative pain intensity, and augmenting the need for analgesia. Moreover, it may contribute to higher rates of postoperative morbidity and mortality following certain types of surgery. This study investigates the anxiolytic and sedative properties of sublingual melatonin as a premedication agent in young females undergoing cesarean section under spinal anesthesia. Methods: A double-blind, randomized, placebo-controlled trial was conducted in Nasiriyah, Iraq. Eighty females were included, 40 in each group, based on specific inclusion and exclusion criteria. Premedication was administered in the morning, 60 minutes before the procedure. In the melatonin group (M), patients received 10 mg of sublingual melatonin, while the placebo group (P) received placebo premedication. Anxiety and sedation levels were evaluated three times: before taking premedication, five minutes before the insertion of the spinal needle, and one hour postoperatively, using the visual analog scale and Richmond Sedation Scale. Results: The results show a highly significant P-value regarding anxiety levels between the M Group and P Group (p-value < 0.001). There was a significant difference in the median sedation scores between the studied groups at pre-spinal insertion and postoperatively (p-value < 0.001). The mean heart rate in the M Group was significantly lower than in the P Group (p-value = 0.0019). Significant differences were noted in systolic and diastolic blood pressures between the two groups, measured five minutes before and after spinal needle insertion (p-value < 0.001). Conclusion: These findings contribute to understanding the impact of sublingual melatonin as an anxiolytic and sedative premedication agent on patients undergoing elective cesarean sections under spinal anesthesia. Further research is warranted to fully elucidate the benefits and implications of melatonin administration in such procedures.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Assessing the Premedication Properties of Sublingual Melatonin in Young Women Undergoing Cesarean Section With Spinal Anesthesia: A Double-Blind Randomized Study

Alkhfaji,

Hussein,

Mutar

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“…Numerous studies have demonstrated the efficacy of melatonin in reducing perioperative anxiety. A prospective clinical study ( Khare et al, 2018 ) found that administering 6 mg of melatonin orally to adult patients 120 min before the induction of general anesthesia provides superior anti-anxiety effects compared to administering 0.25 mg of alprazolam to adult patients. Melatonin administration resulted in less sedation and better preservation of cognitive and psychomotor function.…”

Section: Melatonin For Anti-anxiety and Improvement Of Sleep Disorder...mentioning

confidence: 99%

The relationship between anesthesia and melatonin: a review

Guo,

Ye,

Liao

et al. 2023

Front. Pharmacol.

View full text Add to dashboard Cite

Introduction: This comprehensive review delves into the intricate and multifaceted relationship between anesthesia and melatonin, aiming to provide essential insights for perioperative clinical anesthesiologists and stimulate interest in related research. Anesthesia and surgery have the potential to disrupt melatonin secretion, leading to sleep disorders, postoperative neurocognitive dysfunction and other symptoms. In comparison to previous reviews, this review provides a comprehensive summary of the various aspects linking melatonin and anesthesia, going beyond isolated perspectives. It explores the potential benefits of administering melatonin during the perioperative period, including alleviating anxiety, reducing pain, enhancing perioperative sleep quality, as well as demonstrating immunomodulatory and anti-tumor effects, potentially offering significant advantages for cancer surgery patients.Recent Findings: Anesthesia and surgery have a significant impact on melatonin secretion, the hormone crucial for maintaining circadian rhythms. These procedures disrupt the normal secretion of melatonin, leading to various adverse effects such as sleep disturbances, pain, and postoperative neurocognitive dysfunction. However, the administration of exogenous melatonin during the perioperative period has yielded promising results. It has been observed that perioperative melatonin supplementation can effectively reduce anxiety levels, improve pain management, enhance the quality of perioperative sleep, and potentially decrease the occurrence of postoperative delirium. In recent years, studies have found that melatonin has the potential to improve immune function and exhibit anti-cancer effects, further underscoring its potential advantages for patients undergoing cancer surgery.Summary: In summary, melatonin can serve as an adjuvant drug for anesthesia during the perioperative period. Its administration has demonstrated numerous positive effects, including anti-anxiety properties, sedation, analgesia, improved postoperative sleep, and the potential to reduce the incidence of postoperative delirium. Furthermore, its immune-modulating and anti-tumor effects make it particularly valuable for cancer surgery patients. However, further studies are required to determine the optimal dosage, long-term safety, and potential adverse reactions associated with melatonin administration.

show abstract

“…В этом отношении М рассматривается как альтернатива (или дополнение) кортикостероидам или опиоидам, которые, в отличие от М, оказывают иммуносупрессивное действие. Кроме того, М может быть альтернативой бензодиазепиновому анксиолитику алпразоламу при хирургических процедурах [36]. М также может быть востребован в качестве вспомогательной терапии, улучшающей качество жизни больных, так как бессонница, тревожность, беспокойство, депрессия, боль и другие симптомы сопутствуют онкологическим заболеваниям [37][38][39].…”

Section: обзоры литературыunclassified

Relevance of Further Clinical Trials of the Use of Melatonin in Adjuvant Cancer Therapy

Smorodin

2021

Rossijskij bioterapevtičeskij žurnal

View full text Add to dashboard Cite

The review was compiled from a PubMed, Web of Science, Scopus and Google search, which showed a lack of information on clinical studies of melatonin (M) in oncology, despite numerous and promising experimental results. In preliminary clinical studies carried out by P. Lissony and his co‑authors, the therapeutic potential of M as an adjuvant in chemotherapy, radiation therapy and immunotherapy at different tumor localizations is noted. M alleviates the toxic effect of standard therapy and, according to the authors’ observations, increases its effectiveness. Exogenous M can be in demand as a circadian rhythm synchronizer for rehabilitation and im‑ provement of the quality of life of patients, because reduces distress and improves sleep, and in supportive and palliative therapy. Oncostatic activity of M is associated with the effect on: a) homeostasis and circadian rhythms, b) inflammation, cooperation of immunocytes and cytokine production in the tumor microenvironment, c) gene expression and signalling pathways associated with angiogenesis, proliferation and metastasis, d) metabolism, hypoxia and oxidative stress, e) apoptosis and resistance to chemotherapy and radiation therapy. The review contains the following sections: physiological and pharmacological studies, epidemiological studies, clinical studies, the immunoregulatory role of melatonin, experimental studies. Currently, randomized and long‑term clinical studies of homogeneous groups of patients with tumor stages II−III are in demand for statistical processing of information of the M influence on the side effects of standard therapy, on the dy‑ namics of the disease, clinical parameters, as well as on the quality and duration of life after the main treatment.

show abstract

Comparison of effects of oral melatonin with oral alprazolam used as a premedicant in adult patients undergoing various surgical procedures under general anesthesia: A prospective randomized placebo-controlled study

Cited by 9 publications

References 19 publications

Assessing the Premedication Properties of Sublingual Melatonin in Young Women Undergoing Cesarean Section With Spinal Anesthesia: A Double-Blind Randomized Study

Assessing the Premedication Properties of Sublingual Melatonin in Young Women Undergoing Cesarean Section With Spinal Anesthesia: A Double-Blind Randomized Study

The relationship between anesthesia and melatonin: a review

Relevance of Further Clinical Trials of the Use of Melatonin in Adjuvant Cancer Therapy

Contact Info

Product

Resources

About