Department of Anesthesiology and Reanimation, School of Medicine, Selcuk University, Konya, Turkey.
J Anesth. 2010 Apr;24(2):155-60. doi: 10.1007/s00540-010-0891-8. Epub 2010 Feb 26.
Our intention was to assess the effectiveness of preoperative oral melatonin medication on sedation, sleep quality, and postoperative analgesia in patients undergoing elective prostatectomy.
Fifty-two ASA I-II patients undergoing elective prostatectomy were included in this study, randomly divided into two groups. Patients received an oral placebo (n = 26) or 6 mg melatonin (n = 26) the night before and 1 h before surgery. All patients received a standard anesthetic protocol. At the end of surgery, all patients received tramadol i.v. via a PCA device. Extubation time, intraoperative fentanyl consumption, and recovery time were assessed at the end of the operation. Pain scores, tramadol consumption, and sedation scores were assessed at 1, 2, 4, 6, 12, 18, and 24 h postoperatively, and sleep quality and subjective analgesic efficacy were assessed at 24 h after surgery.
There were no significant differences in demographic data between the groups. Extubation time and recovery time from anesthesia were significantly longer in the melatonin group (P < 0.05). Intraoperative fentanyl usage, pain scores, and tramadol consumption were significantly lower in the melatonin group (P < 0.05). The postoperative sleep quality of patients was significantly better in the melatonin group than in the control group (P < 0.05). Postoperative VAS of pain was significantly lower in the melatonin group compared with the control group at 1, 2, 4, 6, 12, 18, and 24 h postoperatively (P < 0.05). Subjective analgesic efficacy of patients was significantly different between groups (P < 0.05). The sedation scores were significantly higher in the melatonin group than in the control group at 1 h and 2 h after surgery (P < 0.05).
Preoperative oral melatonin administration decreased pain scores and tramadol consumption and enhanced sleep quality, sedation scores, and subjective analgesic efficacy during the postoperative period.
评估术前口服褪黑素对择期前列腺切除术患者镇静、睡眠质量和术后镇痛的效果。
本研究纳入 52 例 ASA I-II 级择期前列腺切除术患者，随机分为两组。患者在术前一晚和手术前 1 小时口服安慰剂（n = 26）或 6 mg 褪黑素（n = 26）。所有患者均接受标准麻醉方案。手术结束时，所有患者均通过 PCA 设备静脉给予曲马多。评估手术结束时的拔管时间、术中芬太尼用量和恢复时间。评估术后 1、2、4、6、12、18 和 24 小时的疼痛评分、曲马多用量和镇静评分，并在术后 24 小时评估睡眠质量和主观镇痛效果。
两组患者的人口统计学数据无显著差异。褪黑素组的拔管时间和麻醉恢复时间明显长于对照组（P < 0.05）。褪黑素组术中芬太尼用量、疼痛评分和曲马多用量明显低于对照组（P < 0.05）。褪黑素组患者术后睡眠质量明显优于对照组（P < 0.05）。与对照组相比，褪黑素组患者在术后 1、2、4、6、12、18 和 24 小时的术后 VAS 疼痛评分明显降低（P < 0.05）。两组患者的主观镇痛效果有显著差异（P < 0.05）。褪黑素组在术后 1 小时和 2 小时的镇静评分明显高于对照组（P < 0.05）。
术前口服褪黑素可降低疼痛评分和曲马多用量，提高睡眠质量、镇静评分和术后主观镇痛效果。
