Abstract：
Posttraumatic and postsurgical sensory disturbance is a known complication of almost all zygomaticomaxillary (ZMC) complex fractures involving the infraorbital nerve, for which few treatments are effective. Our study used neurosensory assessments to evaluate the efficacy of melatonin on pain and nerve healing following ZMC surgery. Sixty-four randomly allocated ZMC fracture patients were prophylactically administered either oral melatonin or an identical placebo for 15 consecutive days. Pre- and postsurgical clinical parameters included subjective pain, numbness, and objective neurosensory function. Melatonin significantly reduced subjective pain perception in the early postoperative days, with a significant difference in VAS scores between the groups from postoperative day 3 (p = 0.048) until day 7 (p = 0.002). The VAS assessment of subjective numbness perception showed significantly lower self-perceived neurosensory disturbance for patients in the interventional group from the first month (p = 0.039) until the third month (p = 0.005). Objective neurosensory assessment using the pinprick test and two-point discrimination showed statistically significant improvement to almost normal sensation by the first month (p = 0.014) to fully normal sensation by the third month (p = 0.001). The study findings suggest that the prophylactic administration of melatonin confers significant clinical benefits in terms of reduced postoperative pain and improved sensory recovery.
摘要：
创伤后和手术后感觉障碍是几乎所有累及眶下神经的杂结腋窝（ZMC）复杂骨折的已知并发症，很少有有效的治疗方法。我们的研究使用神经感觉评估来评估褪黑素对ZMC手术后疼痛和神经愈合的疗效。64名随机分配的ZMC骨折患者连续15天预防性口服褪黑激素或相同的安慰剂。术前和术后临床参数包括主观疼痛，麻木,和客观的神经感觉功能。褪黑素显著降低术后早期的主观疼痛感觉，从术后第3天（p=0.048）到第7天（p=0.002），两组之间的VAS评分存在显着差异。主观麻木感知的VAS评估显示，从第一个月（p=0.039）到第三个月（p=0.005），介入组患者的自我感知神经感觉障碍显着降低。使用针刺测试和两点辨别进行的客观神经感觉评估显示，到第一个月（p=0.014），到第三个月（p=0.001），几乎正常感觉的统计学显着改善。研究结果表明，预防性施用褪黑激素在减轻术后疼痛和改善感觉恢复方面具有显着的临床益处。
