Melatonin as premedication for laparoscopic cholecystectomy: a double-blind, placebo-controlled study

Authors

  • D Ionescu University of Medicine and Pharmacy Iuliu Hatieganu
  • C Bãdescu Clinica ATI
  • A Ilie Clinica ATI
  • I Miclutia University of Medicine and Pharmacy Iuliu Hatieganu
  • C Iancu University of Medicine and Pharmacy Iuliu Hatieganu
  • D Ion University of Medicine and Pharmacy Carol Davila
  • H Vasian University of Medicine and Pharmacy, Cluj-Napoca, Romania
  • C Bondor University of Medicine and Pharmacy, Cluj-Napoca, Romania
  • I Acalovschi Clinica ATI, Spitalul Clinic de AdulÅ£i, Cluj-Napoca, Romania
  • T Mocan University of Medicine and Pharmacy Iuliu Hatieganu

Keywords:

anaesthetics, premedication, midazolam, melatonin, general anaesthesia

Abstract

Background: There are only a few studies involving the use of melatonin for premedication for anaesthesia. The goal of our study was to compare the effects of melatonin and midazolam administered as premedication for laparoscopic cholecystectomy. Methods: This double-blind, placebo-controlled study included 53 patients (ASA I, II) undergoing laparoscopic cholecystectomy under general anaesthesia. The patients were divided into three groups: group 1 (n=18) included patients receiving 3 mg melatonin the night before and as premedication; group 2 (n=17) included the patients receiving 3,75 mg midazolam (1/2 of a 7,5 mg tablet) by the same protocol as for melatonin; and group 3 (n=18) included patients receiving placebo tablets. Preoperatively, the anxiety and sedation scores, as well as the quality of pre-anaesthetic sleep, were evaluated. Postoperatively, the anxiety and sedation scores and the number of remembered pictures were evaluated at 15 and 60 minutes and 6, 12 and 24 hours respectively. The intra-anaesthetic opioid requirements and the severity of postoperative pain (VAS) were also evaluated. Results: The anxiety scores were lower in the melatonin group than in the midazolam group in both the pre- and postoperative period. The scores for the remembered pictures were consistently better in the melatonin group. Postoperatively, the sedation score was significantly lower in the melatonin group, as were the intra-anaesthetic opioid requirements. The severity of postoperative pain was also lower in comparison to midazolam and the placebo. Conclusions: Melatonin (3 mg) can be successfully used as a premedication for laparoscopic cholecystectomy, especially If the patients are operated on day-case basis, because of the perioperative anxiolysis, a certain analgesic effect and a better recovery profile.

Author Biographies

D Ionescu, University of Medicine and Pharmacy Iuliu Hatieganu

Senior Lecturer Anaesthesia and Intensive Care Department

C Bãdescu, Clinica ATI

Registrar in Anaesthesia and Intensive Care

A Ilie, Clinica ATI

Registrar in Anaesthesia and Intensive Care

I Miclutia, University of Medicine and Pharmacy Iuliu Hatieganu

Assistant Professor in Psychiatry, Psychiatry Department

C Iancu, University of Medicine and Pharmacy Iuliu Hatieganu

Department of Surgery

D Ion, University of Medicine and Pharmacy Carol Davila

Department of Physiology

H Vasian, University of Medicine and Pharmacy, Cluj-Napoca, Romania

Assistant Anaesthesia and Intensive Care Department

C Bondor, University of Medicine and Pharmacy, Cluj-Napoca, Romania

Assistant Department of Medical Statistics

I Acalovschi, Clinica ATI, Spitalul Clinic de Adulţi, Cluj-Napoca, Romania

, MD, PhD, FRCA, FCARCSIProfessor in Anaesthesia and Intensive Care,

T Mocan, University of Medicine and Pharmacy Iuliu Hatieganu

Department of Physiology

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Published

2008-08-07

Issue

Section

Scientific Letters