title: Evaluation of the Analgesic Efficacy of Melatonin in Patients Undergoing Cesarean Section Under S pinal Anesthesia: A Prospective Randomized Double-blind Study.
abstract: Melatonin has been suggested as a new natural pain killer in inflammatory pain and during surgical procedures. We designed this randomized double-blind controlled study to evaluate the analgesic efficacy and also optimal preemptive dose of melatonin in patients undergoing cesarean section under spinal anesthesia . One hundred twenty patients scheduled for cesarean section under spinal anesthesia were randomly allocated to one of three groups of 40 each to receive melatonin 3 milligram (mg) (group M3), melatonin 6 mg (group M6) or placebo (group P) sublingually 20 min before the spinal anesthesia. The time to first analgesic request, analgesic requirement in the first 24 h after surgery, hemodynamic variables, anxiety scores nd the incidence of adverse events were recorded. The duration of anesthesia and analgesia didn't show significant differences between three groups. Total analgesic request during 24 h after surgery was different among the three groups (P = 0.035). The incidence of headache in group M6was significantly higher than others (P<0.001). However, after adjusting headache between groups of the study, we were unable to show the significant difference in the total analgesic request during 24 h after surgery among the three groups (p = 0.058). Although premedication of patients with 3 mg sublingual melatonin prolonged time to first analgesic request after cesarean delivery compared to placebo group, the difference was not statistically significant. Meanwhile increasing dose of melatonin to 6 mg failed to enhance analgesia and also increase the incidence of headache in patients undergoing cesarean section under spinal anesthesia.
authors.affiliation: Qazvin University of Medical Science, Department of Anesthesiology, Faculty of Medicine, Shahid Bahonar Ave, PO Box 3419759811, Qazvin, Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Beigom Khezri
authors.affiliation: Department of Anesthesiology , Faculty of Medicine, Qazvin University of Medical Sciences.
authors.forename: Morteza
authors.initials: M
authors.lastname: Delkhosh Reihany
authors.affiliation: Community and preventive medicine, Faculty of medicine, Qazvin University of Medical Sciences.
authors.forename: Sonia
authors.initials: S
authors.lastname: Oveisy
authors.affiliation: Community and preventive medicine, Faculty of medicine, Iran University of Medical Sciences.
authors.forename: Navid
authors.initials: N
authors.lastname: Mohammadi
keywords: Analgesia; Cesarean section; Melatonin; Spinal anesthesia