Literature DB >> 32341662

Safety and Efficacy of Oral Melatonin When Combined with Thoracic Epidural Analgesia in Patients with Bilateral Multiple Fracture Ribs.

Ahmed M Fetouh Abdelrahman1, Amany Faheem Abdel Salam Omara1, Alaa Ali M Elzohry2.   

Abstract

BACKGROUND: The purpose of this study is to evaluate the safety and efficacy of oral melatonin administered with thoracic epidural analgesia in patients with multiple bilateral fractured ribs. PATIENTS AND METHODS: A prospective, double-blind randomized control study was carried out on 80 patients of either sex, American Society of Anesthesiologists (ASA) Grade I and II, aged above 18 years, presenting with multiple bilateral fractured ribs. They were randomly divided into two groups, 40 patients each. Placebo group patients received oral placebo tablets and melatonin group (TEA and melatonin) patients received oral melatonin tablets (5 mg), about 1 hour before epidural infusion of local anesthetics and then every 12 hours till the cessation of bupivacaine infusion.
RESULTS: Melatonin administration was associated with a significant decrease in total morphine analgesia consumption, from 31.8 ± 1.41 mg in the TE group to 13.03 ± 0.85 mg in the melatonin group (P < 0.001), with a significant decrease (P < 0.001) in the mean infusion rate of bupivacaine required for controlling the pain, from 0.17 ± 0.014 mL/kg/hour in the TE group to 0.12 ± 0.001 mL/kg/hour in the melatonin group. The duration of bupivacaine infusion in the melatonin group was also significantly shorter than in the TE group (96.48 ± 1.87 and 100.05 ± 3.39 hours, resp., P < 0.001).
CONCLUSION: We conclude that premedication of patients with 5 mg melatonin is associated with significant prolongation of thoracic epidural analgesic effects compared to placebo. REGISTRATION: This clinical study was registered at Pan African Clinical Trial Registry with no. "PACTR 201711002741378" on 02-11-2017.
© 2020 Abdelrahman et al.

Entities:  

Keywords:  acute pain; fracture ribs; melatonin; thoracic epidural analgesia; visual analogue score

Year:  2020        PMID: 32341662      PMCID: PMC7166071          DOI: 10.2147/LRA.S244510

Source DB:  PubMed          Journal:  Local Reg Anesth        ISSN: 1178-7112


  23 in total

1.  Melatonin improves tourniquet tolerance and enhances postoperative analgesia in patients receiving intravenous regional anesthesia.

Authors:  Hany A Mowafi; Salah A Ismail
Journal:  Anesth Analg       Date:  2008-10       Impact factor: 5.108

2.  Impact of Melatonin on Sleep and Pain After Total Knee Arthroplasty Under Regional Anesthesia With Sedation: A Double-Blind, Randomized, Placebo-Controlled Pilot Study.

Authors:  Meghan A Kirksey; Daniel Yoo; Thomas Danninger; Ottokar Stundner; Yan Ma; Stavros G Memtsoudis
Journal:  J Arthroplasty       Date:  2015-06-21       Impact factor: 4.757

3.  Serious complications related to regional anesthesia: results of a prospective survey in France.

Authors:  Y Auroy; P Narchi; A Messiah; L Litt; B Rouvier; K Samii
Journal:  Anesthesiology       Date:  1997-09       Impact factor: 7.892

4.  Effects of preoperative oral melatonin medication on postoperative analgesia, sleep quality, and sedation in patients undergoing elective prostatectomy: a randomized clinical trial.

Authors:  Hale Borazan; Sema Tuncer; Naime Yalcin; Atilla Erol; Seref Otelcioglu
Journal:  J Anesth       Date:  2010-02-26       Impact factor: 2.078

Review 5.  Potential use of melatonergic drugs in analgesia: mechanisms of action.

Authors:  Venkataramanujam Srinivasan; Seithikurippu R Pandi-Perumal; D Warren Spence; Adam Moscovitch; Ilya Trakht; Gregory M Brown; Daniel P Cardinali
Journal:  Brain Res Bull       Date:  2010-01-19       Impact factor: 4.077

6.  Melatonin provides anxiolysis, enhances analgesia, decreases intraocular pressure, and promotes better operating conditions during cataract surgery under topical anesthesia.

Authors:  Salah A Ismail; Hany A Mowafi
Journal:  Anesth Analg       Date:  2009-04       Impact factor: 5.108

7.  Melatonin versus placebo in the prophylaxis of cluster headache: a double-blind pilot study with parallel groups.

Authors:  M Leone; D D'Amico; F Moschiano; F Fraschini; G Bussone
Journal:  Cephalalgia       Date:  1996-11       Impact factor: 6.292

8.  Efficacy of melatonin in the treatment of endometriosis: a phase II, randomized, double-blind, placebo-controlled trial.

Authors:  André Schwertner; Claudia C Conceição Dos Santos; Gislene Dalferth Costa; Alícia Deitos; Andressa de Souza; Izabel Cristina Custodio de Souza; Iraci L S Torres; João Sabino L da Cunha Filho; Wolnei Caumo
Journal:  Pain       Date:  2013-03-05       Impact factor: 6.961

Review 9.  Melatonin: a hormone that modulates pain.

Authors:  Mónica Ambriz-Tututi; Héctor I Rocha-González; Silvia L Cruz; Vinicio Granados-Soto
Journal:  Life Sci       Date:  2009-02-15       Impact factor: 5.037

10.  Preoperative anxiolytic effect of melatonin and clonidine on postoperative pain and morphine consumption in patients undergoing abdominal hysterectomy: a double-blind, randomized, placebo-controlled study.

Authors:  Wolnei Caumo; Rosa Levandovski; Maria Paz L Hidalgo
Journal:  J Pain       Date:  2008-11-17       Impact factor: 5.820

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  1 in total

Review 1.  Molecular Mechanism of Neuroprotective Effect of Melatonin on Morphine Addiction and Analgesic Tolerance: an Update.

Authors:  Ling-Yan Su; Qianjin Liu; Lijin Jiao; Yong-Gang Yao
Journal:  Mol Neurobiol       Date:  2021-06-19       Impact factor: 5.590

  1 in total

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