Premedication with melatonin: a double-blind, placebo-controlled comparison with midazolam

Area of Science:

• Anesthesiology
• Pharmacology
• Neuroscience

Background:

• Preoperative anxiety and sedation are critical factors in patient management.
• Midazolam is a common anxiolytic and sedative, but can cause psychomotor impairment.
• Melatonin, a hormone regulating sleep-wake cycles, has potential anxiolytic and sedative properties.

Purpose of the Study:

• To compare the perioperative effects of melatonin with midazolam and placebo in women undergoing anesthesia.
• To evaluate the impact of melatonin and midazolam premedication on anxiety, sedation, orientation, and psychomotor performance.

Main Methods:

• Prospective, randomized, double-blind, placebo-controlled study with 75 women.
• Administration of sublingual midazolam 15 mg, melatonin 5 mg, or placebo 100 minutes before anesthesia.
• Quantification of sedation, anxiety, orientation, and psychomotor performance (DSST, TDT) at multiple time points.

Main Results:

• Both midazolam and melatonin significantly reduced anxiety and increased sedation preoperatively compared to placebo.
• Midazolam caused greater sedation and preoperative psychomotor impairment than melatonin.
• Postoperatively, both midazolam and melatonin groups showed increased sedation and DSST impairment compared to placebo, with no significant differences in anxiety or TDT performance.

Conclusions:

• Melatonin is an effective premedication option for adult patients, offering anxiolytic and sedative benefits.
• Melatonin provides a favorable alternative to midazolam, with reduced psychomotor impairment.
• Further research into melatonin's perioperative applications is warranted.