Comparison of the effect of melatonin, dexmedetomidine, and gabapentin on reduction of postoperative pain and anxiety following laminectomy: a randomized clinical trial.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968535 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2253 (Electronic) Linking ISSN: 14712253 NLM ISO Abbreviation: BMC Anesthesiol Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2001-

Anti-Anxiety Agents*/therapeutic use ; Dexmedetomidine*/therapeutic use ; Melatonin*/therapeutic use; Adult ; Double-Blind Method ; Gabapentin/therapeutic use ; Humans ; Iran ; Laminectomy ; Middle Aged ; Narcotics/therapeutic use ; Nausea/drug therapy ; Pain, Postoperative/drug therapy ; Pain, Postoperative/prevention & control ; Vomiting

Background: This study aimed to compare the effects of melatonin, dexmedetomidine, and gabapentin on postoperative pain and anxiety following laminectomy.
Methods: In this randomized clinical trial, 99 patients aged 40-60 years old with American Society of Anesthesiologists physical status I-II undergoing laminectomy were divided into three groups receiving 600mg gabapentin (group G), 10mg melatonin (group M), or starch tablets (group D). The Hospital Anxiety and Depression Scale (HADS) was used to measure postoperative anxiety while a Visual Analogue Scale (VAS) was employed to measure pain severity. Patients' satisfaction with pain treatment was also measured together with the frequency of nausea and vomiting.
Results: The postoperative HADS decreased in all groups over time. Time and group had no significant interaction effect on the HADS score. Patients in the melatonin group had lower HADS at 2 and 6h after surgery. According to the VAS, the groups significantly differed in pain scores 6 and 24h after surgery. Lower VAS scores were observed 6h after surgery in the dexmedetomidine group compared with the gabapentin group and 24h after surgery in the dexmedetomidine group compared with the gabapentin and melatonin groups. Narcotic requirements, patients' satisfaction, and vital sign changes did not significantly vary among the groups. Notably, patients in the melatonin group had less nausea and vomiting.
Trial Registration: This study was registered in the Iranian Registry of Clinical Trials (No. IRCT20141009019470N82, 29.06.2019) where the trial protocol could be accessed.
Conclusion: Melatonin is effective as a postoperative anti-anxiety drug. Dexmedetomidine is useful in reducing postoperative pain.
(© 2022. The Author(s).)

Eurasian J Med. 2016 Jun;48(2):135-41. (PMID: 27551178)
Br J Anaesth. 2017 Aug 01;119(2):200-210. (PMID: 28854538)
Integr Cancer Ther. 2012 Dec;11(4):293-303. (PMID: 22019490)
Anesth Analg. 2006 Jul;103(1):121-3, table of contents. (PMID: 16790638)
Trials. 2017 Feb 23;18(1):81. (PMID: 28228148)
Can J Anaesth. 2013 May;60(5):432-43. (PMID: 23377862)
Neurosci Lett. 2014 Feb 21;561:7-12. (PMID: 24373989)
Bosn J Basic Med Sci. 2020 Feb 05;20(1):117-124. (PMID: 31465720)
Br J Radiol. 2020 Aug;93(1112):20200298. (PMID: 32479105)
Br J Anaesth. 2014 Jan;112(1):7-8. (PMID: 24318695)
Korean J Pain. 2014 Oct;27(4):313-20. (PMID: 25317279)
JAMA Surg. 2018 Apr 1;153(4):303-311. (PMID: 29238824)
J Anesth. 2010 Apr;24(2):155-60. (PMID: 20186437)
J Int Med Res. 2019 Oct;47(10):5060-5069. (PMID: 31510871)
Ochsner J. 2018 Summer;18(2):121-125. (PMID: 30258291)
Anesth Pain Med. 2018 Jun 24;8(3):e68763. (PMID: 30214884)
Gen Comp Endocrinol. 2018 Mar 1;258:215-221. (PMID: 28533170)
Yale J Biol Med. 2010 Mar;83(1):11-25. (PMID: 20351978)
Indian J Pharmacol. 2013 Nov-Dec;45(6):581-6. (PMID: 24347765)
Eur Spine J. 2013 Sep;22(9):2089-96. (PMID: 23681498)
J Burn Care Res. 2020 Jan 30;41(1):151-158. (PMID: 31630182)
Eur J Anaesthesiol. 2016 Feb;33(2):75-83. (PMID: 26258655)
J Pain. 2009 Jan;10(1):100-8. (PMID: 19010741)
Turk J Med Sci. 2018 Dec 12;48(6):1219-1227. (PMID: 30541250)
J Craniovertebr Junction Spine. 2015 Jul-Sep;6(3):105-10. (PMID: 26288544)
J Neurosurg. 2006 Mar;104(3):350-9. (PMID: 16572646)
Cah Anesthesiol. 1995;43(6):557-64. (PMID: 8745648)
J Pain Res. 2018 Nov 02;11:2633-2643. (PMID: 30519075)
Anesth Analg. 1991 Aug;73(2):204-8. (PMID: 1649559)
Drugs. 2000 Feb;59(2):263-8; discussion 269-70. (PMID: 10730549)
J Clin Anesth. 2014 Nov;26(7):545-50. (PMID: 25439417)
Anesth Analg. 2007 Nov;105(5):1263-71, table of contents. (PMID: 17959953)
Korean J Pain. 2020 Apr 01;33(2):166-175. (PMID: 32235017)
Anesth Analg. 1995 Mar;80(3):511-4. (PMID: 7864416)
Pain Res Manag. 2018 Jul 9;2018:9834059. (PMID: 30123399)
Qual Life Res. 2019 Nov;28(11):3107-3116. (PMID: 31230167)
Anaesthesia. 2014 Oct;69(10):1163-71. (PMID: 24835540)
Drug Dev Ind Pharm. 2016 Dec;42(12):1917-1927. (PMID: 27595299)

Keywords: Analgesics; Anxiety; Dexmedetomidine; Gabapentin; Laminectomy; Melatonin; Pain; Sedation

0 (Anti-Anxiety Agents)
0 (Narcotics)
67VB76HONO (Dexmedetomidine)
6CW7F3G59X (Gabapentin)
JL5DK93RCL (Melatonin)

Date Created: 20221015 Date Completed: 20221018 Latest Revision: 20240905

20250114

PMC9569101

10.1186/s12871-022-01851-x

36243712