PDF(Pubmed)
Abstract：
BACKGROUND: Preoperative anxiety can negatively impact patient outcomes by influencing the intraoperative requirements for anesthetics and analgesics, increasing postoperative pain intensity, and augmenting the need for analgesia. Moreover, it may contribute to higher rates of postoperative morbidity and mortality following certain types of surgery. This study investigates the anxiolytic and sedative properties of sublingual melatonin as a premedication agent in young females undergoing cesarean section under spinal anesthesia.
METHODS: A double-blind, randomized, placebo-controlled trial was conducted in Nasiriyah, Iraq. Eighty females were included, 40 in each group, based on specific inclusion and exclusion criteria. Premedication was administered in the morning, 60 minutes before the procedure. In the melatonin group (M), patients received 10 mg of sublingual melatonin, while the placebo group (P) received placebo premedication. Anxiety and sedation levels were evaluated three times: before taking premedication, five minutes before the insertion of the spinal needle, and one hour postoperatively, using the visual analog scale and Richmond Sedation Scale.
RESULTS: The results show a highly significant P-value regarding anxiety levels between the M Group and P Group (p-value < 0.001). There was a significant difference in the median sedation scores between the studied groups at pre-spinal insertion and postoperatively (p-value < 0.001). The mean heart rate in the M Group was significantly lower than in the P Group (p-value = 0.0019). Significant differences were noted in systolic and diastolic blood pressures between the two groups, measured five minutes before and after spinal needle insertion (p-value < 0.001).
CONCLUSIONS: These findings contribute to understanding the impact of sublingual melatonin as an anxiolytic and sedative premedication agent on patients undergoing elective cesarean sections under spinal anesthesia. Further research is warranted to fully elucidate the benefits and implications of melatonin administration in such procedures.
METHODS: A double-blind, randomized, placebo-controlled trial was conducted in Nasiriyah, Iraq. Eighty females were included, 40 in each group, based on specific inclusion and exclusion criteria. Premedication was administered in the morning, 60 minutes before the procedure. In the melatonin group (M), patients received 10 mg of sublingual melatonin, while the placebo group (P) received placebo premedication. Anxiety and sedation levels were evaluated three times: before taking premedication, five minutes before the insertion of the spinal needle, and one hour postoperatively, using the visual analog scale and Richmond Sedation Scale.
RESULTS: The results show a highly significant P-value regarding anxiety levels between the M Group and P Group (p-value < 0.001). There was a significant difference in the median sedation scores between the studied groups at pre-spinal insertion and postoperatively (p-value < 0.001). The mean heart rate in the M Group was significantly lower than in the P Group (p-value = 0.0019). Significant differences were noted in systolic and diastolic blood pressures between the two groups, measured five minutes before and after spinal needle insertion (p-value < 0.001).
CONCLUSIONS: These findings contribute to understanding the impact of sublingual melatonin as an anxiolytic and sedative premedication agent on patients undergoing elective cesarean sections under spinal anesthesia. Further research is warranted to fully elucidate the benefits and implications of melatonin administration in such procedures.
摘要：
背景：术前焦虑会通过影响术中对麻醉药和镇痛药的需求而对患者的预后产生负面影响，增加术后疼痛强度，增加镇痛的需求。此外，它可能导致某些类型手术后更高的术后发病率和死亡率。这项研究调查了舌下褪黑素作为前药在脊髓麻醉下剖宫产的年轻女性中的抗焦虑和镇静特性。
方法：双盲，随机化，安慰剂对照试验在纳西里耶进行，伊拉克。包括80名女性，每组40人,根据具体的纳入和排除标准。早上给药，手术前60分钟。在褪黑激素组（M）中，患者接受了10毫克舌下褪黑素，而安慰剂组（P）接受安慰剂前用药。焦虑和镇静水平进行了三次评估：服用前，在插入脊髓针前五分钟,术后一小时，使用视觉模拟量表和里士满镇静量表。
结果:结果显示关于M组和P组之间的焦虑水平的高度显著的P值(p值<0.001)。在脊柱插入术前和术后，研究组之间的中位镇静评分存在显着差异（p值<0.001）。M组的平均心率明显低于P组（p值=0.0019）。两组之间的收缩压和舒张压存在显着差异，脊柱穿刺针插入前后五分钟测量（p值<0.001）。
结论：这些发现有助于了解舌下褪黑素作为一种抗焦虑和镇静性的前用药药物对脊柱麻醉下择期剖宫产患者的影响。需要进一步的研究来充分阐明褪黑激素在此类程序中的益处和含义。
方法：双盲，随机化，安慰剂对照试验在纳西里耶进行，伊拉克。包括80名女性，每组40人,根据具体的纳入和排除标准。早上给药，手术前60分钟。在褪黑激素组（M）中，患者接受了10毫克舌下褪黑素，而安慰剂组（P）接受安慰剂前用药。焦虑和镇静水平进行了三次评估：服用前，在插入脊髓针前五分钟,术后一小时，使用视觉模拟量表和里士满镇静量表。
结果:结果显示关于M组和P组之间的焦虑水平的高度显著的P值(p值<0.001)。在脊柱插入术前和术后，研究组之间的中位镇静评分存在显着差异（p值<0.001）。M组的平均心率明显低于P组（p值=0.0019）。两组之间的收缩压和舒张压存在显着差异，脊柱穿刺针插入前后五分钟测量（p值<0.001）。
结论：这些发现有助于了解舌下褪黑素作为一种抗焦虑和镇静性的前用药药物对脊柱麻醉下择期剖宫产患者的影响。需要进一步的研究来充分阐明褪黑激素在此类程序中的益处和含义。
