Thursday, April 23, 2020

Melatonin for procedure

Q: What is the role of Melatonin in reducing procedural anxiety?


Answer: 

Benzodiazepines are the first line of pre-medications for the treatment of procedural anxiety. If a patient is not a candidate for benzodiazepines, 3-5 mg of sublingual melatonin can be given with a good comparable effect. The dose can be repeated in 30 to 60 minutes if needed. 

Sublingual melatonin has an anxiolytic and sedative effect. Its use is limited by less psychomotor impairment and quicker recovery time than midazolam, the most widely used pre-procedural drug.


#surgical-critical-care

#pharmacology


References:


1. Naguib M, Samarkandi AH. The comparative dose-response effects of melatonin and midazolam for premedication of adult patients: a double-blinded, placebo-controlled study. Anesth Analg 2000; 91:473. 


 2. Acil M, Basgul E, Celiker V, et al. Perioperative effects of melatonin and midazolam premedication on sedation, orientation, anxiety scores and psychomotor performance. Eur J Anaesthesiol 2004; 21:553. 


3. Ionescu D, Bãdescu C, Ilie A, et al. Melatonin as premedication for laparoscopic cholecystectomy: a double-blind, placebo-controlled study. South Afr J Anaesth Analg 2008; 14:8.

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