Melatonin Decreased Postoperative Pain after Abdominal Hysterectomy: A Randomized, Double-blind, Placebo-controlled Trial
Keywords:
Melatonin, Hysterectomy, Postoperative painAbstract
Background: Incidence of anxiety and pain in patients undergoing hysterectomy is significant and primarily due to postoperative pain. Most patients usually receive opioids for pain control. Melatonin is a natural hormone produced by the body. Synthetic melatonin is available over the counter for the management of insomnia and jetlag. Clinically, melatonin can also be used to reduce pain and analgesic requirement in patients undergoing surgery. The analgesic benefit of melatonin as primary or adjuvant agents has been reported in various studies.
Objective: We aimed to study whether melatonin could improve pain and other postoperative conditions after hysterectomy.
Methods: A randomized, double-blinded, placebo-controlled trial study was carried out on 54 women undergoing hysterectomy, with or without oophorectomy under spinal anesthesia. Patients were allocated randomly to receive either 4 mg prolonged-release melatonin at night and in the morning before surgery or 2 doses of placebo. Morphine consumption within 24 hours, visual analog scale (VAS) pain score, quality of sleep, anxiety level score, fatigue, general well-being and satisfaction score were measured.
Results: Morphine consumption in melatonin group was significantly low compared to placebo (33.04 ± 10.42 and 42.63 ± 8.21 mg, (p < 0.001). Also, postoperative VAS pain scale was lower in the melatonin group at recovery room arrival (23.41 vs 8.07, p = 0.01). Postoperative fatigue, general well-being and satisfaction scores in the melatonin group were better than the placebo group.
Conclusion: Prolonged-release formulation of melatonin decreased pain intensity in post anesthetic care room and reduced morphine consumption within 24 hours after surgery. Melatonin may be an additional choice of multimodal analgesia for hysterectomy.
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