A comparative study between oral melatonin and oral midazolam on preoperative anxiety, cognitive, and psychomotor functions.
A comparative study between oral melatonin and oral midazolam on preoperative anxiety, cognitive, and psychomotor functions.
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DOI：
10.4103/0970-9185.150534
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Kurdi MS
中科院分区：
文献类型：
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作者：
Patel T;Kurdi MS
褪黑素是人体内自然产生的一种激素，据报道可以在不影响定向的情况下引起术前焦虑和镇静。以下研究的目的是评估和比较口服褪黑素和口服咪达唑仑对术前焦虑、镇静、精神运动和认知功能的影响。一项研究对120名年龄16-55岁的美国麻醉师学会1级和2级择期手术患者进行了研究，每组使用褪黑素、咪达唑仑和安慰剂40例。患者在诱导前60-90分钟给予口服褪黑素0.4 mg/kg或口服咪达唑仑0.2 mg/kg或安慰剂。采用视觉模拟量表（VAS）焦虑评分、定向评分和镇静评分，研究患者用药前和用药后60-90 min的焦虑情况。采用数字符号替代测验（DSST）和轨迹测验（TMT）研究受试者的精神运动和认知功能。资料采用卡方检验或Kruskal-Wallis方差分析，以P < 0.05为差异有统计学意义。褪黑素组与安慰剂组比较（P = 0.0124），咪达唑仑组与安慰剂组比较（P = 0.0003）， VAS焦虑评分变化显著。褪黑素与咪达唑仑比较，VAS焦虑评分差异无统计学意义（P = 0.49）。组间比较镇静评分显示，与安慰剂相比，褪黑素（P = 0.0258）和咪达唑仑（P = 0.0000）具有统计学意义。褪黑素组和安慰剂组的取向得分没有变化。仅咪达唑仑组DSST评分和TMT评分变化显著。口服褪黑素0.4 mg/kg具有与口服咪达唑仑相当的充分的抗焦虑作用。与咪达唑仑不同，口服褪黑素0.4 mg/kg不会损害一般认知和精神运动功能，特别是认知方面，如工作记忆、记忆检索、持续注意力和思维灵活性。
Melatonin, a naturally occurring hormone in the human body, has been reported to cause preoperative anxiolysis and sedation without impairing orientation. The aim of the following study was to evaluate and to compare the effects of oral melatonin and oral midazolam on preoperative anxiety, sedation, psychomotor, and cognitive function. A study conducted on 120 patients aged 16-55 years, of American Society of Anesthesiologists Grade 1 and 2 posted for elective surgery, with each group of melatonin, midazolam, and placebo comprising 40 patients. Patients were given either 0.4 mg/kg oral melatonin or 0.2 mg/kg oral midazolam or a placebo 60-90 min before induction. Preoperative anxiety was studied before and 60-90 min after giving medications using visual analog scale (VAS) anxiety score, orientation score, and sedation score. Psychomotor and cognitive functions were studied using the digit symbol substitution test (DSST) and trail making test (TMT) tests. Data were analyzed using Chi-square test or Kruskal–Wallis analysis of variance and the value of P < 0.05 was considered as statistically significant. Changes in VAS anxiety scores were significant when melatonin was compared with placebo (P = 0.0124) and when midazolam was compared with placebo (P = 0.0003). When melatonin was compared with midazolam, no significant difference (P = 0.49) in VAS anxiety scores was observed. Intergroup comparison of sedation scores showed melatonin (P = 0.0258) and midazolam (P = 0.0000) to be statistically significant when compared with placebo. No changes in orientation scores occurred in melatonin and placebo group. Change in DSST scores and TMT scores were seen to be significant only in midazolam group. Oral melatonin 0.4 mg/kg provides adequate anxiolysis comparable to that of oral midazolam. Unlike midazolam, oral melatonin 0.4 mg/kg does not impair the general cognitive and psychomotor function especially cognitive aspects such as working memory, memory retrieval, sustained attention, and flexibility of thinking.