Premedication with melatonin vs midazolam: efficacy on anxiety and compliance in paediatric surgical patients.
Study Goal
The researchers aimed to evaluate the effectiveness of oral melatonin compared to midazolam in reducing preoperative anxiety in children undergoing elective surgery and assessing compliance during anesthesia induction.
Results Summary
Melatonin was as effective as midazolam in reducing children's preoperative anxiety and improving compliance during anesthesia induction, with no significant differences between the two treatments.
Population
Children undergoing elective surgery (80 participants, 40 per group).
Effective Dosage
0.5 mg/kg (max 20 mg), single oral dose.
Duration
Single dose administered preoperatively.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
oral melatonin premedication | decrease | preoperative anxiety | children undergoing elective surgery | - | reducing | #1 |
oral melatonin premedication | increase | compliance to induction of anaesthesia | children undergoing surgery | - | improving | #2 |
oral melatonin premedication | no change | preoperative anxiety levels | children premedicated with melatonin and midazolam | - | did not show significant differences | #3 |
oral melatonin premedication | no change | compliance during anaesthesia induction | children premedicated with melatonin and midazolam | - | similar | #4 |
midazolam | no change | preoperative anxiety levels | children premedicated with melatonin and midazolam | - | did not show significant differences | #5 |
midazolam | no change | compliance during anaesthesia induction | children premedicated with melatonin and midazolam | - | similar | #6 |
melatonin | decrease | children's anxiety | children | - | as effective as midazolam in reducing | #7 |
UNLABELLED: Preoperative anxiety is a major problem in paediatric surgical patients. Melatonin has been used as a premedicant agent and data regarding effectiveness are controversial. The primary outcome of this randomized clinical trial was to evaluate the effectiveness of oral melatonin premedication, in comparison to midazolam, in reducing preoperative anxiety in children undergoing elective surgery. As secondary outcome, compliance to intravenous induction anaesthesia was assessed. There were 80 children undergoing surgery randomly assigned, 40 per group, to receive oral midazolam (0.5 mg/kg, max 20 mg) or oral melatonin (0.5 mg/kg, max 20 mg). Trait anxiety of children and their mothers (State-Trait Anxiety Inventory) at admission, preoperative anxiety and during anaesthesia induction (Modified Yale Pre-operative Anxiety Scale), and children's compliance with anaesthesia induction (Induction Compliance Checklist) were all assessed. Children premedicated with melatonin and midazolam did not show significant differences in preoperative anxiety levels, either in the preoperative room or during anaesthesia induction. Moreover, compliance during anaesthesia induction was similar in both groups. CONCLUSIONS: This study adds new encouraging data, further supporting the potential use of melatonin premedication in reducing anxiety and improving compliance to induction of anaesthesia in children undergoing surgery. Nevertheless, further larger controlled clinical trials are needed to confirm the real effectiveness of melatonin as a premedicant agent in paediatric population. What is Known: • Although midazolam represents the preferred treatment as a premedication for children before induction of anaesthesia, it has several side effects. • Melatonin has been successfully used as a premedicant agent in adults, while data regarding effectiveness in children are controversial. What is New: • In this study, melatonin was as effective as midazolam in reducing children's anxiety in both preoperative room and at induction of anaesthesia.