Efficacy of Melatonin as an adjuvantin lower limb surgeries performed under spinal anaesthesia and its role in preventing post- operative delirium.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 3
Abstract
Introduction: Postoperative delirium (POD) is usually seen in patients of any age and even upto5 days after surgery. Melatonin (N-acetyl-5-methoxytryptamine) is pineal hormone used in sleep disorders and for anxiolysis. It has a curative effect on POD.Aims & objectives: To study the efficacy of melatonin in reducing the incidence of POD in patients undergoing lower limb surgeries under spinal anaesthesia. Alsoto study the haemodynamic variables, analgesic effects and complications.Material & Methods: This prospectivedoubleblind control study was conducted on 60 patients, randomized into two groups.Group P(n=30): Received two tablets of placeboat 9.00 PM and 90 minutes before surgery orally. Group M(n=30): Received two tablets of melatonin (3mg each) at 9.00 PM and 90 minutes before surgery orallySpinal anaesthesia was administered in sitting position at L3-L4 lumbar space. Intraoperatively vital parameters were monitored at regular intervals of 15 minutes. Sedation score and Abbreviated Mental Test {AMT} were noted prior to administration of morning dose of melatonin. AMT repeated on the same day and three days postoperatively. Patients having scores lesser than 8 were considered to develop postoperative delirium, were further administered melatonin & assessed (AMT) for three days. Data wereanalysed by two-way analysis of variance (ANOVA) and t-test as applicable. P values <0.05 were considered significant. Results & Conclusion: Melatonin was effective in preventing post- operative delirium in patients undergoing lower limb surgery under spinal anaesthesia. It also prolonged the requirement of first rescue analgesia.
Authors and Affiliations
Dr. Manish Aggarwal, Dr. Priyamvada Gupta, Dr. Durga Jethava, Dr. Dharam Das Jethava
Keywords
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- DOI 10.9790/0853-1703071019.
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