Assessing the Effects of Premedication Using Oral Melatonin on Quality of Sedation and Pain Control During and After Cataract Surgery under Sedation and Local Anesthesia

Mojtaba Rahimi  Varposhti; Behzad  Nazemroaya; Shahrzad  Andalib

doi:10.18502/aacc.v11i3.18483

Mojtaba Rahimi Varposhti Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Behzad Nazemroaya Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Shahrzad Andalib Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

DOI: https://doi.org/10.18502/aacc.v11i3.18483

Keywords: Premedication; Melatonin; Cataract; Sedation; Pain

Abstract

Background: Providing adequate sedation in patients undergoing cataract surgery, can create analgesia and sedation during injection and retrobulbar surgery in order to prevent eye movement during open eye surgery. This study was aimed at assessing the effects of melatonin premedication on the quality of sedation and pain control during cataract surgery.

Methods: The study was a triple-blind randomized clinical trial that was performed in Isfahan on 40 patients. The patients were allocated randomly into two groups of 20 subjects, one group receiving 3 mgs of sublingual melatonin pill and another group 3mgs of placebo. This was done 60 minutes prior to surgery.

Hemodynamic parameters, level of pain, and sedation were measured at specific intervals. In order to measure the level of pain and sedation, the VAS score and Richmond scales were used, respectively.

Results: Surgery duration (P value=0.059), duration of anesthesia (P value=0.14), duration of recovery (P value=0.34), ASA (P value=0.27), Richmond scale (P value=0.45), oxygen saturation level (P value=0.12), and PR (P value=0.87) did not show a significant difference between the two groups. The changes in mean arterial pressure (P value=0.02) and pain intensity (P value=0.04) were significantly higher in the placebo group compared to the melatonin group.

Conclusion: Premedication with oral melatonin was beneficial in providing better pain control and hemodynamic stability in patients undergoing cataract surgery under sedation and local anesthesia.