The Effect of Melatonin on Anxiety and Pain of Tourniquet in Intravenous Regional Anesthesia
The Effect of Melatonin on Anxiety and Pain of Tourniquet in Intravenous Regional Anesthesia
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DOI：
10.4103/abr.abr_106_19
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发表时间：
2019-01-01
影响因子：
1
通讯作者：
Sane, Shahryar
中科院分区：
文献类型：
--
作者：
Abbasivash, Rahman;Salimi, Sohrab;Sane, Shahryar
背景：褪黑素具有抗焦虑和潜在的镇痛作用。一些研究表明，在手术前使用褪黑激素作为前用药时，具有镇静和抗焦虑的作用。因此，我们评估了褪黑素对接受静脉区域麻醉(IVRA)的患者止血带相关疼痛和镇痛的效果。材料和方法：选择在IVRA下行手部手术的患者50例，随机分为两组，每组25例，分别口服褪黑素6 mg(褪黑素组)和安慰剂(对照组)。静脉注射利多卡因3 mg/kg，用生理盐水稀释至总容量40mL。记录焦虑评分、感觉和运动阻滞起效和恢复时间、止血带疼痛和24小时止痛药需求量。结果：M组运动、感觉阻滞起效时间明显缩短(P<；0.001)，运动、感觉阻滞恢复时间明显延长(P<；0.001)。M组止血带起痛时间较长(P<；0.001)。研究组焦虑评分为3+/-0.81，对照组为4.2+/-1.04(P=0.001)。两组患者对阿片类药物的需求差异有统计学意义(P<；0.05)。结论：褪黑素是IVRA前有效的术前用药，因为它减少了患者的焦虑，减少了止血带相关的疼痛，并改善了围手术期的止痛。
Background: Melatonin has anxiolytic and potential analgesic effects. Several studies have indicated the sedative and anti-anxiety effects of melatonin when used as premedication before surgery. Hence, we assessed the efficacy of melatonin premedication in tourniquet-related pain and analgesia in patients receiving intravenous regional anesthesia (IVRA). Materials and Methods: Fifty patients undergoing elective hand surgery under IVRA were randomly divided into two groups (25 patients each) to receive either melatonin 6 mg (melatonin group) or placebo (control group) as oral premedication. IVRA was achieved with lidocaine, 3 mg/kg, diluted with saline to a total volume of 40 mL. Anxiety scores, sensory and motor block onset and recovery times, tourniquet pain, and 24-h analgesic requirements were recorded. Results: The onset of motor and sensory block was statistically significantly shorter in Group M (P < 0.001), and recovery of motor and sensory block was statistically significantly longer in Group M (P < 0.001). The time of starting tourniquet pain was longer in Group M (P < 0.001). The mean anxiety score in the study group was 3 +/- 0.81 and in the control group was 4.20 +/- 1.04 (P = 0.001). There was a statistically significant difference in the need for opioids between the two groups (P < 0.05). Conclusions: Melatonin is an effective premedication before IVRA because it reduces patient anxiety, decreases tourniquet-related pain, and improves perioperative analgesia.