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No effect of melatonin to modify surgical-stress response after major vascular surgery: a randomised
B Kücükakin1, M Wilhelmsen, J Lykkesfeldt
1Department of Surgical Gastroenterology, University of Copenhagen, Herlev Hospital, DK-2730 Herlev, Denmark.
Background:
A possible mechanism underlying cardiovascular morbidity after major vascular surgery may be the perioperative ischaemia-reperfusion with excessive oxygen-derived free-radical production and increased levels of circulating inflammatory mediators. We examined the effect of melatonin infusion during surgery and oral melatonin treatment for 3 days after surgery on biochemical markers of oxidative and inflammatory stress.
Methods:
Patients received an intra-operative intravenous infusion of 50 mg melatonin or placebo. In addition, all patients received 10 mg melatonin or placebo orally the first 3 nights after surgery. Blood samples for analysis of malondialdehyde (MDA), ascorbic acid (AA), dehydroascorbic acid (DHA) and C-reactive protein (CRP) were collected preoperatively, and at 5 min, 6 h and 24 h after clamp removal (recirculation of the first leg).
Results:
Twenty-six patients received melatonin and 24 patients received placebo. No significant differences were observed in any of the oxidative and inflammatory stress parameters. There were significantly more side effects in the melatonin group than in the placebo group.
Conclusions:
Melatonin treatment in the perioperative period did not reduce the oxidative and inflammatory parameters measured in this study.
Insights
Perioperative melatonin administration did not reduce oxidative and inflammatory stress markers after major vascular surgery. Melatonin treatment was associated with more side effects compared to placebo.
Area of Science:
- Cardiovascular Surgery
- Oxidative Stress
- Inflammatory Response
Background:
- Major vascular surgery can lead to cardiovascular complications potentially due to ischemia-reperfusion injury.
- This injury involves excessive free-radical production and elevated inflammatory mediators.
Purpose of the Study:
- To investigate the impact of perioperative melatonin on oxidative and inflammatory stress markers.
- To assess the safety and efficacy of melatonin in patients undergoing major vascular surgery.
Main Methods:
- A randomized controlled trial involving intravenous and oral melatonin administration.
- Measurement of malondialdehyde, ascorbic acid, dehydroascorbic acid, and C-reactive protein preoperatively and postoperatively.
Main Results:
- No significant differences in oxidative or inflammatory stress markers between melatonin and placebo groups.
- A higher incidence of side effects was reported in the melatonin group.
Conclusions:
- Perioperative melatonin did not attenuate measured oxidative and inflammatory parameters.
- Melatonin treatment in this context was associated with increased adverse events.
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