Melatonin vs. midazolam premedication in children: a double-blind, pl...

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http://www.ncbi.nlm.nih.gov/pubmed/15852991

Abstract
Eur J Anaesthesiol. 2005 Mar;22(3):189-96.

Melatonin vs. midazolam premedication in children: a double-blind,

placebo-controlled study.
Samarkandi A1, Naguib M, Riad W, Thalaj A, Alotibi W, Aldammas F, Albassam A.

Author information
Abstract
BACKGROUND AND OBJECTIVE: Unlike midazolam, melatonin premedication is not associated with
cognitive impairment in adults despite its anxiolytic properties. The use of melatonin as a premedicant in
children has not been reported. This randomized, double-blind, placebo-controlled study compared the
perioperative effects of different doses of melatonin and midazolam in children.
METHODS: Seven groups of children (n = 15 in each) were randomly assigned to receive one of the
following premedicants. Midazolam 0.1, 0.25 or 0.5 mg kg(-1) orally, melatonin 0.1, 0.25 or 0.5 mg kg(-1)
orally each mixed in 15 mg kg(-1) acetaminophen, or placebo only (15 mg kg(-1) acetaminophen). Anxiety
and temperament were evaluated before and after administration of the study drug, on separation from
parents and on the introduction of the anaesthesia mask. At week 2 postoperatively, the behaviour of the
children was measured by the Post Hospitalization Behaviour Questionnaire.
RESULTS: Melatonin or midazolam each in doses of 0.25 or 0.5 mg kg(-1) were equally effective as
premedicants in alleviating separation anxiety and anxiety associated with the introduction of the
anaesthesia mask. A trend was noted for midazolam to prolong recovery times as the dosage increased.
The use of melatonin was associated with a lower incidence (P = 0.049) of excitement at 10 min
postoperatively, and a lower incidence (P = 0.046) of sleep disturbance at week 2 postoperatively than
that observed with midazolam and control groups. No postoperative excitement was noted in the
melatonin groups at 20, 30 and 45 min.
DISCUSSION: Melatonin was not only as effective as midazolam in alleviating preoperative anxiety in
children, but it was also associated with a tendency towards faster recovery, lower incidence of
excitement postoperatively and a lower incidence of sleep disturbance at week 2 postoperatively.
PMID: 15852991 [PubMed - indexed for MEDLINE]

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