The Effects of Oral Melatonin on Preoperative Anxiety,Sedation and Induction Dose of Propofol in a Tertiary Care Centre.A Randomised Placebo Control Study.

Anxiety is common in surgical patients during the preoperative period. Preoperative anxiety is described as an unpleasant state of uneasiness or tension that is secondary to a patient being concerned about a disease, hospitalization, anaesthesia and surgery, or the unknown. It may cause patients to avoid planned surgery. If anxiety is marked it causes all the signs of sympathetic stimulation and stress. High levels of preoperative anxiety have unfavourable effects on induction and maintenance of anaesthesia as well as on the recovery from anaesthesia and surgery. Anxious patients require higher doses of anaesthetic induction agents and postoperative analgesic drug. Hence the most important single reason for premedicating patients before surgery is to reduce anxiety. Reducing anxiety is an important goal in good anaesthesia management.

Melatonin (N-acetyl-5-methoxytryptamine) is a hormone naturally produced in the brain, secreted by the pineal gland, whose receptors are found throughout the central nervous system and other body tissues. It is known to be an effective hormone in sleep disorders, anxiety, and pain, as well as an anti-inflammatory antioxidant, used as a premedication.

A dose range of melatonin premedication is used to provide sedation and analgesia without cognitive impairment and psychomotor skills, and without any increase in recovery time. Several studies reported that melatonin has analgesic potential in addition to anxiolytic and sedative effects without disturbances of the cognitive and psychomotor skills and thus improves the quality of recovery.• Considering these facts, the present study is planned to assess the effects of melatonin on preoperative anxiolysis, sedation and induction dose of propofol. Its hypnotic and anesthetic sparing properties is studied by evaluating the induction dose of propofol