Melatonin as a premedication for laparoscopic cholecystectomy

Daniela Ionescu¹, Cristina Bădescu², Alice Ilie², I. Acalovschi¹
1) Catedra ATI, UMF Cluj-Napoca. 2) Medici rezidenţi ATI

Abstract

There are only a few studies involving the use of melatonin for premedication of anaesthesia. The goal of this study was to compare the effects of melatonin and midazolam, administered as a premedication for laparoscopic cholecystectomy.

Methods and patients. 45 patients (ASA I/II) undergoing laparoscopic cholecystectomy were divided into three equal groups. Group 1 included the patients receiving 3 mg melatonin the night before and as a premedication; group 2 comprised patients who had received 3.7 mg midazolam using the same protocol as for melatonin and, finally, group 3 included patients receiving placebo tablets. In the preoperative period the anxiety and sedation scores as well as the quality of preanesthetic sleep were evaluated. Postoperatively the anxiety and sedation scores and the number of remembered pictures were evaluated at 15 min, 60 min, 6h, 12h and 24h, respectively. The intraanesthetic opioid consumption and the severity of postoperative pain (on VAS) were evaluated also.

Results. The anxiety score was lower in the melatonin group compared with midazolam in both preoperative and postoperative period. The score of remembered pictures was constantly better in the melatonin group. The sedation score was significantly lower in melatonin group postoperatively. Also, the severity of postoperative pain and the intraanaesthetic opioid needs were lower in the melatonin group compared with midazolam.

Conclusion. Melatonin 3 mg p.o. can be successfully administered in comparison with midazolam, as a premedication for laparoscopic cholecystectomy, taking into consideration the analgetic effect and a reduced opioid consumption, together with a better anxiety score and better intellectual performances determined in these patients.

Key words: general anaesthesia, premedication, melatonin

Melatonina în premedicaţia pentru colecistectomia laparoscopică

Jurnalul Român de Anestezie Terapie intensivă 2004 Vol.11 Nr.1, 16-20