The effects of premedication melatonin on anxiety and hemodynamic stability for patients undergoing cesarean section: A randomized controlled study

Hussein alkhfaji 1, Mohamed Kahloul 2, Talib Razak M Askar 3, Majid Fakhir Alhamaidah 4, Hussein Ali Hussein 5
1Department of Anesthesia, College of Health and Medical Technology, Al-Ayen University, Iraq, Bent AL Huda hospital, Iraqi ministry of health. Iraq
2Department of Anesthesia and Intensive Care, Teaching Hospital of Sahloul, University of Medicine Ibn Jazzar, Sousse, Tunisia
3Thi qar University Medical College. Iraq
4Department of Anesthesia, College of Health and Medical Technology, Al-Ayen University, Iraq
5Department of Anesthesia, College of Health and Medical Technology, Al-Ayen University, Iraq

ABSTRACT

Background: Premedication carries some significant goals during general anesthesia, it regulates the hemodynamic, relieve anxiety, induces sedation, offers proper analgesia and reduces the need for anesthetic drugs. Study objectives: The aim of this study was to evaluate the efficiency of Melatonin as a premedication agent for patients undergoing elective cesarean section on anxiety and blood pressure. Methods: The study included 80 individuals who were scheduled for elective spinal anesthesia-based cesarean sections. We assigned them at random. every group has 40 patients, melatonin group (M) and placebo group (P). The dose was given to patient at two separated times; at night and 90 minutes before the operation (10 mg) sublingually per each dose. Anxiety was evaluated for three times; pre the administration of the second dose (premedication) of melatonin, before the insertion of spinal needle and after 1 hour postoperatively by using Visual Analogue Scale. Hemodynamics were monitored) SBP, DBP and MAP) using a Nihon Kohden patient monitor during preoperative, after 5 min, 10 min, 20 min, 15 min, 60 min and 120 min. Result: This study included 80 patients, divided into two groups, including 40 patients, the melatonin group) M), as well as the placebo group (P) 40 patients. The results showed a decrease in the level of anxiety in the melatonin group before and after surgery p value (<0.001). as well as mean value was lower in melatonin group at min 120 postoperative, and this difference was statistically significant (p><0.05). Conclusions: The results of the present study showed that the use of 10 mg of melatonin at night and 90 min before cesarean section with spinal anesthesia is not only safe, but also reduces level of anxiety of patients’, regulate blood pressure pre and post-operative.><0.001) . as well as mean value was lower in melatonin group at min 120 postoperative, and this difference was statistically significant (p<0.05). Conclusions: The results of the present study showed that the use of 10 mg of melatonin at night and 90 min before cesarean section with spinal anesthesia is not only safe, but also reduces level of anxiety of patients’, regulate blood pressure pre and post-operative.

Keywords:Melatonin, Spinal anesthesia, Hemodynamic, Blood pressure, Anxiety, Pre-operative, Postoperative, Premedication..