Comparison of Oral Melatonin and Midazolam as Premedication in Children Undergoing General Anesthesia for Dental Treatment

Faghihian, Reyhaneh; Eshghi, Alireza; Faghihian, Hessamoddin; Kaviani, Naser

doi:10.5812/aapm.64236

Cited by 14 publications

(39 citation statements)

References 16 publications

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“…As a premedicant, it has been used in children in a dose of 0.25–0.5 mg/kg 60 min prior to induction with varying results. [141516]…”

Section: Sedative Premedicationmentioning

confidence: 99%

Premedication and induction of anaesthesia in paediatric patients

Dave

2019

Indian J Anaesth

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Perioperative anxiety has been associated with adverse clinical outcomes such as emergence delirium, increased analgesic requirements and negative postoperative behavioural changes such as sleep disturbance, separation anxiety, eating problems and new-onset enuresis. Predictors of preoperative anxiety have been identified, and these include, among other factors, the age and temperament of the child. Any plan for anaesthetic induction in a child must take into account these factors. The anaesthetic plan must be individualised for special situations, for example, the child with behavioural disorder or at risk of aspiration. This article details the pharmacological and nonpharmacological methods to minimise preoperative anxiety and the techniques of anaesthetic induction in infants and children undergoing surgery. The benefits and limitations of inhalational and intravenous induction and the current status of rapid sequence induction in children are discussed. MEDLINE database was searched for this narrative review using the keywords including preoperative anxiety, child, premedication, paediatric and anaesthetic induction. Search was restricted to articles in English, but without any publication date restrictions.

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“…As a premedicant, it has been used in children in a dose of 0.25–0.5 mg/kg 60 min prior to induction with varying results. [141516]…”

Section: Sedative Premedicationmentioning

confidence: 99%

Premedication and induction of anaesthesia in paediatric patients

Dave

2019

Indian J Anaesth

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“…The studies included in this review highlight the use of Of the 27 studies identified, only 7 (26%) were placebocontrolled, thus limiting the robustness of data on the effectiveness of melatonin. Another issue was the dosing variability of melatonin, with some studies using a dose per kg body weight and others using a fixed dose [50][51][52][53][54][55][56][57]. The oral bioavailability of melatonin is variable, ranging from 1 to 56%, with a mean of approximately 15% [58][59][60].…”

Section: Discussionmentioning

confidence: 99%

Melatonin for anaesthetic indications in paediatric patients: a systematic review

et al. 2020

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The favourable safety profile and ubiquitous nature of melatonin has led to an increase in its use in various clinical settings in adults and children. We performed a systematic review of published studies on the use of melatonin for anaesthetic indications in paediatric patients. To identify relevant articles, PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Scopus databases were searched. Study title and abstract screening, and full text review were performed by two reviewers. Twentyseven eligible studies investigating melatonin use for anaesthetic indications were identified. Due to significant heterogeneity in study methodology, a quantitative synthesis of the published findings was not possible. The identified studies were therefore categorised by the indication for melatonin: analgesia, diagnostic sedation and as an anaesthetic adjunct. Melatonin use for anaesthetic-related indications is safe; may provide analgesia for inflammatory-associated pain in neonates and children before venepuncture; may decrease the need for, or replace, general anaesthesia for diagnostic procedures; and may serve as an anaesthesia adjunct before induction in paediatric patients.

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“…[ 18 ] compared the effect of oral melatonin and midazolam in alleviating preoperative anxiety and observed that preoperative melatonin administration is not effective in alleviating anxiety, as compared to midazolam. Faghihian et al [ 19 ]’s clinical trial randomly divided 132 children who were general anesthesia candidates for dental treatment into three groups receiving midazolam, melatonin, and normal saline as premedication, assessing and recording sedation scores before general anesthesia, easy venipuncture, the need for pain relief, and recovery time. Their result suggested that midazolam was preferable to melatonin as a premedication because of more sedation, easier venipuncture, less need for pain relief, and better recovery in children under general anesthesia for dental treatment, compared to melatonin, whereas our study showed better sedation score, ease of separation from parents, and admission of anesthesia with midazolam than melatonin.…”

Section: Discussionmentioning

confidence: 99%

Comparison the oral premedication of midazolam, dexmedetomidine, and melatonin for children’s sedation and ease of separation from parents before anesthesia

et al. 2020

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A BSTRACT Background: Children’s fear of surgery and preoperative separation from parents can contribute to anxiety and distress in children undergoing surgery. The study addressed the comparable efficacy of oral premedication of midazolam, dexmedetomidine, and melatonin to alleviate preoperative anxiety and easing the children’s separation from parents. Materials and Methods: A double-blinded trial enrolled three equal-sized groups of children ( n = 153, aged 2–10 years) undergoing elective surgery who received oral midazolam, melatonin, and dexmedetomidine 30 min before induction. The observation sedation score, and ease of separation, acceptance of drug both preceding and following premedication administration were assessed and recorded every 5min till anesthesia induction. Results: A significant difference was observed in the mean scores of sedation before premedication and after separation from parents, as well as in the degree of the separation when comparing between the midazolam and melatonin groups and the dexmedetomidine and melatonin groups ( P < 0.001). The scores were significantly lower in the melatonin group than the other two groups, whereas no significant difference was found in those between the midazolam and dexmedetomidine groups, as well as in the acceptance of anesthesia induction between the midazolam and melatonin groups ( P = 0.250). The differences were significant between the midazolam and dexmedetomidine groups ( P = 0.002) and melatonin and dexmedetomidine groups ( P < 0.001) and anesthesia induction was effective in the dexmedetomidine group than that in the other two groups. Conclusion: Dexmedetomidine is more effective in acceptance of anesthesia induction. Furthermore, the midazolam and dexmedetomidine groups indicated better ease of separation and sedation scores than melatonin.

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Comparison of Oral Melatonin and Midazolam as Premedication in Children Undergoing General Anesthesia for Dental Treatment

Cited by 14 publications

References 16 publications

Premedication and induction of anaesthesia in paediatric patients

Premedication and induction of anaesthesia in paediatric patients

Melatonin for anaesthetic indications in paediatric patients: a systematic review

Comparison the oral premedication of midazolam, dexmedetomidine, and melatonin for children’s sedation and ease of separation from parents before anesthesia

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