Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Menoufia University, Shibin El Kom, Egypt.
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Menoufia University, Shibin El Kom, Egypt -
Minerva Anestesiol. 2024 Jun;90(6):509-519. doi: 10.23736/S0375-9393.24.17888-1.
The current study was designed to evaluate the role of prophylactic melatonin administration in reducing delirium occurrence in elderly patients undergoing colorectal cancer surgeries.
One hundred patients of both genders undergoing elective colorectal cancer surgeries under general anesthesia were randomly allocated into two equal groups. A treatment group of patients (Melatonin group) received five mg of melatonin the night before surgery, twelve hours before the scheduled surgery time, and an additional five mg of melatonin two hours before surgery. The control group of patients received placebo tablets at the same time points. Delirium score, sedation score, pain score, hemodynamics, oxygen saturation, and blood requirements were recorded.
Twenty-eight patients (56%) in the control group versus 18 (36%) in the melatonin group developed delirium (P=0.045), OR=2.26, 95% CI: 1.013-5.05. Five patients (18%) in the control group versus six (33%) in the melatonin group developed delirium on discharge from the recovery room (P=0.749), OR=1.22, 95% CI: 0.34-4.31, while 23 patients (82%) in the control group versus 12 (66%) in the melatonin group developed delirium six hours postoperative (P=0.021), OR=1.705, 95% CI: 1.02-2.81 with higher nursing delirium screening score in the control group 2 (1, 4) versus 1 (0, 2) in the melatonin group (P=0.002), 95% CI: 1.77-2.71.
The prophylactic administration of melatonin may decrease the incidence of postoperative delirium in elderly patients undergoing colorectal surgeries under general anesthesia.
本研究旨在评估预防性给予褪黑素对接受结直肠手术的老年患者发生谵妄的作用。
100 名择期全身麻醉下接受结直肠手术的男女患者被随机均分为两组。治疗组（褪黑素组）患者在手术前夜、术前 12 小时和术前 2 小时给予 5mg 褪黑素。对照组患者在相同时间点给予安慰剂片剂。记录谵妄评分、镇静评分、疼痛评分、血流动力学、血氧饱和度和血液需求。
对照组 28 例（56%）患者发生谵妄，褪黑素组 18 例（36%）（P=0.045），OR=2.26，95%CI：1.013-5.05。对照组 5 例（18%）患者在恢复室出院时发生谵妄，褪黑素组 6 例（33%）（P=0.749），OR=1.22，95%CI：0.34-4.31，而对照组 23 例（82%）患者在术后 6 小时发生谵妄，褪黑素组 12 例（66%）（P=0.021），OR=1.705，95%CI：1.02-2.81，对照组的护理谵妄筛查评分较高，为 2（1，4），而褪黑素组为 1（0，2）（P=0.002），95%CI：1.77-2.71。
预防性给予褪黑素可降低全身麻醉下接受结直肠手术的老年患者术后谵妄的发生率。
