Comparison of the effects of preoperative melatonin or vitamin C administration on postoperative analgesia

Bosnian Journal of Basic Medical Sciences
Q2
Aug 2019
Citations:32
Influential Citations:2
Interventional (Human) Studies
86
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Methods
Prospective, double-blind, randomized, controlled trial of 165 adults (18–65 years; ASA I–II; both sexes) undergoing elective major abdominal surgery with general anesthesia; three-arm design (melatonin, vitamin C, placebo).
Intervention
Preoperative oral melatonin 6 mg (single dose, 1 hour before surgery); preoperative oral vitamin C 2 g (single dose, 1 hour before surgery).
Results
Preoperative single-dose melatonin (6 mg) or vitamin C (2 g) reduced postoperative pain scores (VAS) within 24 hours and lowered total morphine consumption via PCA compared with placebo. Melatonin: 20.1 ± 6.8 mg; Vitamin C: 22.2 ± 6.5 mg; Placebo: 24.6 ± 8.4 mg (24 h). Both groups required less supplemental diclofenac and experienced fewer nausea/vomiting episodes (p < 0.05). No significant difference between melatonin and vitamin C for pain or morphine use. Melatonin was associated with higher early sedation and longer recovery time. Conclusion: A single preoperative dose of melatonin or vitamin C can act as opioid-sparing adjuvants in elective major abdominal surgery, improving analgesia and reducing opioid-related adverse effects; further dose- and route-optimization studies are needed.
Limitations
Diclofenac used as rescue analgesic rather than opioids; plasma levels of melatonin and vitamin C not measured; heterogeneity of surgical procedures and no sex-specific analyses.

Abstract

The analgesic benefit of melatonin and vitamin C as primary or adjuvant agents has been reported in various studies; however, their analgesic effects in the treatment of postoperative pain remain unclear. Thus, we aimed to evaluate the effect of sing...