Melatonin premedication for patients undergoing phacoemulsification cataract surgery under topical anesthesia

ABSTRACT

We hypothesized that melatonin premedication in adult patients undergoing cataract surgery could produce anxiolysis, Improve analgesia and reduce intraocular pressure. Forty patients were randomly allocated into two equal groups [20 patients each]. Ninety minutes before surgery, each patient received sublingual 5 mg melatonin tablet [melatonin group] or placebo tablet [control group]. Anxiety and pain scores, heart rate [HR], mean arterial pressure [MAP], and intraocular pressure [IOP] changes were evaluated. Following premedication, the anxiety scores were lower in the melatonin group [p < 0.05]. There were also significantly lower intraoperative verbal pain scale [VPS] scores at 10 and 30 minutes during surgery and postoperatively with less intraoperative fentanyl consumption in the melatonin group [33.6 +/- 18.4 vs. 68.8 +/- 32.4 micro g, p < 0.001] IOP decreased significantly after melatonin premedication and at the end of surgery in the melatonin group compared to the control group [p < 0.05]. Sublingual 5 mg melatonin premedication in patients undergoing phacoemulsification cataract surgery under topical anesthesia reduced anxiety, and enhanced intraoperative and early postoperative analgesia. It also results in ocular hypotensive effects and better operating conditions