No effect of melatonin to modify surgical-stress response after major vascular surgery: a randomised placebo-controlled trial.
Study Goal
The researchers aimed to determine whether perioperative melatonin treatment could reduce oxidative and inflammatory stress markers in patients undergoing major vascular surgery.
Results Summary
Melatonin treatment did not significantly reduce oxidative or inflammatory stress parameters compared to placebo. The melatonin group reported significantly more side effects than the placebo group.
Population
Patients undergoing major vascular surgery.
Effective Dosage
Intra-operative intravenous infusion of 50 mg melatonin, followed by 10 mg melatonin orally for the first 3 nights after surgery.
Duration
Intra-operative infusion plus 3 days post-surgery.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
melatonin infusion during surgery and oral melatonin treatment for 3 days after surgery | no change | oxidative and inflammatory parameters | patients | no significant differences | did not reduce | #1 |
melatonin infusion during surgery and oral melatonin treatment for 3 days after surgery | no change | malondialdehyde (MDA) | patients | no significant differences | No significant differences were observed in | #2 |
melatonin infusion during surgery and oral melatonin treatment for 3 days after surgery | no change | ascorbic acid (AA) | patients | no significant differences | No significant differences were observed in | #3 |
melatonin infusion during surgery and oral melatonin treatment for 3 days after surgery | no change | dehydroascorbic acid (DHA) | patients | no significant differences | No significant differences were observed in | #4 |
melatonin infusion during surgery and oral melatonin treatment for 3 days after surgery | no change | C-reactive protein (CRP) | patients | no significant differences | No significant differences were observed in | #5 |
melatonin | increase | side effects | patients | significantly more | significantly more | #6 |
BACKGROUND: A possible mechanism underlying cardiovascular morbidity after major vascular surgery may be the perioperative ischaemia-reperfusion with excessive oxygen-derived free-radical production and increased levels of circulating inflammatory mediators. We examined the effect of melatonin infusion during surgery and oral melatonin treatment for 3 days after surgery on biochemical markers of oxidative and inflammatory stress. METHODS: Patients received an intra-operative intravenous infusion of 50 mg melatonin or placebo. In addition, all patients received 10 mg melatonin or placebo orally the first 3 nights after surgery. Blood samples for analysis of malondialdehyde (MDA), ascorbic acid (AA), dehydroascorbic acid (DHA) and C-reactive protein (CRP) were collected preoperatively, and at 5 min, 6 h and 24 h after clamp removal (recirculation of the first leg). RESULTS: Twenty-six patients received melatonin and 24 patients received placebo. No significant differences were observed in any of the oxidative and inflammatory stress parameters. There were significantly more side effects in the melatonin group than in the placebo group. CONCLUSIONS: Melatonin treatment in the perioperative period did not reduce the oxidative and inflammatory parameters measured in this study.