Jouybar Reza, Zohoori Kambiz, Khademi Saeed, Akhlagh Seyed Hedayatallah, Mani Arash, Akhlagh Seyed Amir Reza, Asadpour Elham
Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Research Center for Psychiatry and Behavior Sciences Shiraz University of Medical Sciences, Shiraz, Iran.
J Res Med Sci. 2023 Mar 16;28:14. doi: 10.4103/jrms.jrms_118_21. eCollection 2023.
Cognitive dysfunction presents one of the chief causes of postoperative morbidity. Melatonin as a neurohormone can improve neurocognitive functioning and sleep disorders. We evaluated the effect of melatonin on the postoperative cognitive function of patients undergoing coronary artery bypass grafting (CABG).
A triple-blind randomized-controlled trial was conducted on 66 CABG candidates in Namazee Hospital (Shiraz, Iran). Patients were assigned equally into two groups receiving melatonin 10 mg or a placebo daily for 4 weeks before surgery and 2 days after surgery in the intensive care unit. The Mini-Mental State Examination (MMSE), Tower of London (ToL), and Wechsler Adults Intelligence Scale-Revised (WAIS-R) cognitive function tests were performed in both groups 4 weeks before surgery (time point 1), 2 days after surgery (time point 2), and 6 weeks after initial administration of melatonin (time point 3).
The mean change score (time point 3-time point 1) differed significantly between the two groups in the MMSE ( ≤ 0.001), ToL total score ( = 0.001), and WAIS-R general IQ ( ≤ 0.001), picture completion ( ≤ 0.001), vocabulary ( = 0.024), and digit span ( = 0.01). On the other hand, no significant differences were detected in the WAIS-R block design, ToL total time delay, ToL total lab, and ToL total result scores.
The MMSE and WAIS-R tests revealed that melatonin might have prophylactic effects against postoperative cognitive disturbance in patients undergoing elective CABG.
认知功能障碍是术后发病的主要原因之一。褪黑素作为一种神经激素，可改善神经认知功能和睡眠障碍。我们评估了褪黑素对冠状动脉搭桥术（CABG）患者术后认知功能的影响。
在纳马齐医院（伊朗设拉子）对66例CABG候选患者进行了一项三盲随机对照试验。患者被平均分为两组，在手术前4周和术后重症监护病房的2天内，每天分别接受10毫克褪黑素或安慰剂治疗。在手术前4周（时间点1）、手术后2天（时间点2）和首次服用褪黑素后6周（时间点3），对两组患者进行简易精神状态检查表（MMSE）、伦敦塔（ToL）和韦氏成人智力量表修订版（WAIS-R）认知功能测试。
两组在MMSE（≤0.001）、ToL总分（=0.001）、WAIS-R一般智商（≤0.001）、图片完成（≤0.001）、词汇（=0.024）和数字广度（=0.01）方面的平均变化得分（时间点3 - 时间点1）差异显著。另一方面，在WAIS-R积木图案、ToL总时间延迟、ToL总实验室和ToL总结果得分方面未检测到显著差异。
MMSE和WAIS-R测试表明，褪黑素可能对择期CABG患者的术后认知障碍具有预防作用。
