Effects of Melatonin Premedication on the Hemodynamic Responses and Perfusion Index During Laryngoscopy and Endotracheal Intubation
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- Category: Vol. 81, December 2013
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Effects of Melatonin Premedication on the Hemodynamic Responses and Perfusion Index During Laryngoscopy and Endotracheal Intubation, AHMED A. MOHAMED, HOSAM M. ATEF, ALAA EL-DIN M. EL KASSABY, SALAH A.M. ISMAIL and AMR M. HELMY
Abstract
Context Rational: Several techniques have been proposed to prevent or attenuate the hemodynamic responses following laryngoscopy and intubation, preoperative melatonin has a significant analgesic and anxiolytic effect for patients under-going surgery. Melatonin may play an important role in controlling hypertension also in humans. The current study aimed at assessing the usefulness of melatonin in attenuating the pressor response to direct laryngoscopy and tracheal intubation.
Methods: After approval of the ethics committee and informed written patients consent the study was carried out at rotine surgical theatre of the Suez Canal University Hospital, during the peroid from 2011 – 2012 on 90 patients with ASA physical status I, II scheduled for any elective surgery under general anesthesia with endotracheal intubation. Patients were randomly allocated according to computer-generated random-ization into three groups: Group I (control group); Group II (melatonin 6mg tablet group) and Group III (melatonin 9mg tablet group). Primary outcome measures include; Heart rate (HR, Systolic blood pressure (SBP), diastolic blood: pressure (DBP), mean arterial pressure (MBP) and perfusion index were recorded before drug premedication, pre-induction, pre-intubation, 1, 2, 3, 5 and 10 minutes after laryngoscopy and intubation. Moreover perioperative anxiety was evaluated by recording the preoperative and postoperative verbal anxiety score (VAS) of the sample patients.
Results: Significant decrease in blood pressure in group II and group III receiving 6mg and 9mg of oral Melatonin 1 hour preoperative at 1, 2, 3, 5 and 10 minutes after intubation as regard SBP, DBP and MBP compared to group I. As regards to heart rate, no significant difference was found between the three groups throughout different time of measurement except for a significant difference at 1 minute after intubation measures for group II and group III compared to the control group. Moreover postoperative verbal anxiety score (VAS) was decreased significantly group II and group III compared to the control group.
Conclusion: Preoperative administration of melatonin one hour before surgery provided a significant decrease hemodynamic response of direct laryngoscopy and tracheal intubation as regard hemodynamic parameters and perfusion index.