The effects of Oral Melatonin on pre operative Anxiety,Sedation and Induction dose of Thiopentone Sodium in a Tertiary Care Centre - A Randomised Placebo control study

During the preoperative period anxiety is commonly seen in patients posted for surgery. An unpleasant state of tension or an uneasy feeling because of patients concern regarding the disease, hospital admission, anesthesia and surgery is described as preoperative-anxiety.It can lead to sympathetic stimulation and in some cases may lead to patient deferring surgery. may cause patients to avoid planned surgery.High levels of preoperative anxiety can have unfavorable effects on induction as well as maintenance of anaesthesia and lead to a delayed recovery from anaesthesia due to higher doses of induction agents and post operative analgesic drugs. An important goal in optimal anaesthetic management is to reduce the anxiety and this can be accomplished by good premedication. Preoperative anxiety can be reduced with certain pharmacological interventions. Benzodiazepines like midazolam is commonly used as a premedication to decrease the levels of anxiety. It has disadvantages like paradoxical reactions, variable bioavalibity, can interact with opioids and lead to a delay in discharge from the post anaesthesia care unit. A naturally occurring neurohormone Melatonin(N-acetyl-5 methoxy tryptamine) is secreted in the human body by the pineal gland. Studies have shown that decrease in pre operative anxiety and sedation can be caused by melatonin without impairing orientation ,psychomotor skills and cognition which in turn improve the quality of recovery. It is a novel hypnotic with anaesthetic sparing effect and a wide safety margin in children a dose of 0.4 mg/kg has been used safely. As a result we designed this study to evaluate the effects of premedication with melatonin on preoperative anxiety and sedation. 2 Considering these facts, the present study is planned to assess the effects of melatonin on preoperative anxiolysis, sedation and induction dose of Thiopentone sodium.