Hostname: page-component-745bb68f8f-f46jp Total loading time: 0 Render date: 2025-01-23T05:05:33.109Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  23 December 2004

M. Acil ,
E. Basgul ,
V. Celiker ,
A. H. Karagöz ,
B. Demir  and
U. Aypar
M. Acil
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
E. Basgul
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
V. Celiker
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
A. H. Karagöz
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
B. Demir
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
U. Aypar
Affiliation:
Hacettepe University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
Get access

Extract

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.

Keywords

ANAESTHETICSINTRAVENOUS, midazolamPREMEDICATIONTRYPTAMINES, melatonin
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 7 , July 2004 , pp. 553 - 557
Copyright
2004 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Wetterberg L. Melatonin and clinical application. Reprod Nutr Dev 1999; 39: 367–382.Google Scholar
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: 789–795.Google Scholar
Pierpaoli W, Maestroni GJ. Melatonin: a principal neuroimmunoregulatory and anti-stress hormone: its anti-aging effects. Immunol Lett 1987; 16: 355–361.Google Scholar
Cramer H, Rudolph J, Consbruch U, Kendel K. On the effects of melatonin on sleep and behavior in man. Adv Biochem Psychopharmacol 1974; 11: 187–191.Google Scholar
Wurtman RJ, Zhdanova I. Improvement of sleep quality by melatonin. Lancet 1995; 346: 1491.Google Scholar
Naguib M, Samarkandi AH. Premedication with melatonin: a double blind, placebo-controlled comparison with midazolam. Br J Anaesth 1999; 82: 875–880.Google Scholar
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: 473–479.Google Scholar
Shafer A, White PF, Urquhart ML, Doze VA. Outpatient premedication: use of midazolam and opioid analgesics. Anesthesiology 1989; 71: 495–501.Google Scholar
Dawson D, Encel N. Melatonin and sleep in humans. J Pineal Res 1993; 15: 1–12.Google Scholar
Kontinen VK, Maunuksela EL, Sarvela J. Premedication with sublingual triazolam compared with oral diazepam. Can J Anesth 1993;40: 829–834.Google Scholar
Cella DF, Perry SW. Reliability and concurrent validity of three visual-analogue mood scales. Psychol Rep 1986; 59: 827–833.Google Scholar
Luria RE. The validity and reliability of the visual analogue mood scale. J Psychiatr Res 1975; 12: 51–57.Google Scholar
Spreen O, Strauss E. A Compendium of Neuropsychological Tests: Administration, Norms and Commentary.Oxford, UK: University Press, 1991: 320–331.
Reitan RM. Validity of the Trail Making Test as an indication of organic brain damage. Perceptual and Motor Skill 1958; 8: 271–276.Google Scholar
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: 673–680.Google Scholar
Lieberman HR, Waldhauser F, Garfield G, Lynch HJ, Wurtman RJ. Effects of melatonin on human mood and performance. Brain Res 1984; 323: 201–207.Google Scholar
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: 301–305.Google Scholar