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Potturi A, Karthik Raj, Reddy NVV, Rajan R, Kumar JD, Bharath YW. Analysis of Effect of Melatonin on Postoperative Sensory Nerve Recovery Following Open Reduction and Internal Fixation of Anterior Mandible Fractures: A Prospective Randomized Control Trial. J Maxillofac Oral Surg 2024; 23:356-362. [PMID: 38601244 PMCID: PMC11001823 DOI: 10.1007/s12663-023-02108-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 12/22/2023] [Indexed: 04/12/2024] Open
Abstract
Purpose Open reduction and internal fixation (ORIF) of the anterior mandibular fractures are commonly associated with mental nerve paraesthesia. This study evaluates the efficacy of melatonin on postoperative sensory functional recovery and pain following surgical treatment of anterior mandibular fractures. Methods Forty patients were randomly allocated to two groups: Group I-melatonin, and Group II-control group. Postoperative neurosensory recovery was evaluated both subjectively and objectively at 1-week, 1-month, and 3-month intervals. The pain was assessed during the immediate postoperative period, postoperative days 1, 2, 3, and 7 using a visual analog scale. Statistical significance was set at P value < 0.05. Results The statistically significant difference was noticed in both subjective and objective recovery of sensory nerve function at 1-month follow-up. All patients in the melatonin group showed complete recovery of nerve function as compared to the control group where 10% of patients showed limited recovery. Conclusion Neurosensory recovery following ORIF of mandibular fractures was better in the melatonin group as compared to the control group and therefore the perioperative administration of 10 mg. Melatonin can be recommended for quicker and better nerve recovery in the anterior mandibular fractures requiring close manipulation of the mental nerve during treatment.
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Affiliation(s)
| | - Karthik Raj
- SVS Institute of Dental Sciences, Hyderabad, Telangana India
| | | | - Ritesh Rajan
- SVS Institute of Dental Sciences, Hyderabad, Telangana India
| | | | - Y. W. Bharath
- SVS Institute of Dental Sciences, Hyderabad, Telangana India
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Hussein HA, Kahloul M, Alhamaidah MF, Alkhfaji HJ. Anxiolytic and Sedative Properties of Melatonin Premedication in Pediatrics Undergoing Elective Cardiac Catheterization: A Randomized Placebo Study. Cureus 2024; 16:e56543. [PMID: 38646369 PMCID: PMC11027787 DOI: 10.7759/cureus.56543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Preoperative anxiety in children has been linked to various postoperative consequences, such as postoperative regressive behavioral issues, extended distress during the recovery period, eating disorders, and bedwetting. The current study aimed to investigate the efficacy of low-dose oral melatonin in alleviating preoperative anxiety among children in the Iraqi population. STUDY DESIGN A randomized, double-blinded comparative study was undertaken, involving children aged four to 14 years scheduled for elective cardiac catheterization under general anesthesia. The study comprised a total of 80 children. The involved individuals were randomly assigned to two groups, each with 40 subjects. Group A received 0.5 mg/kg melatonin as premedication, while Group B received a placebo. RESULTS The two groups demonstrated similarity in mean age, weight, cardiac disease, and gender distribution. Statistically significant reductions in anxiety scores were observed in the melatonin group compared to the placebo group. Particularly, children administered 0.5 mg/kg melatonin exhibited the most substantial anxiolysis and venipuncture compliance (P < 0.05). Additionally, children who were premedicated with melatonin experienced decreased cognition, maximum sedation, successful parental separation, and psychomotor impairment (P < 0.05). CONCLUSIONS Melatonin demonstrated an effective sedation level without significant side effects, making it a preferred choice due to its efficacy, safety, current availability, and cost-effectiveness compared to other anesthetic agents used in premedication procedures.
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Affiliation(s)
- Hussein A Hussein
- Department of Anesthesia and Intensive Care, Faculty of Medicine, University of Sousse, Sousse, TUN
| | - Mohamed Kahloul
- Department of Anesthesia and Intensive Care, Faculty of Medicine, Sahloul Teaching Hospital, University of Sousse, Sousse, TUN
| | - Majid F Alhamaidah
- Department of Anesthesiology, College of Health and Medical Technology, Al-Ayen Iraqi University, Thi-Qar, IRQ
| | - Hussein J Alkhfaji
- Department of Anesthesiology, College of Health and Medical Technology, Al-Ayen Iraqi University, Thi-Qar, IRQ
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Albzea W, Almonayea L, Aljassar M, Atmeh M, Al Sadder K, AlQattan Y, Alhajaji R, AlNadwi H, Alnami I, Alhajaji F. Efficacy and Safety of Preoperative Melatonin for Women Undergoing Cesarean Section: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1065. [PMID: 37374268 DOI: 10.3390/medicina59061065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/26/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023]
Abstract
Background: Cesarean section (CS) has been linked to a number of negative effects, such as pain, anxiety, and sleeping problems. The aim of this systematic review and meta-analysis was to investigate the safety and efficacy of preoperative melatonin on postoperative outcomes in pregnant women who were scheduled for elective CS. Methods: We systemically searched 4 electronic databases (PubMed, Scopus, Web of Science, and Cochrane Library) from inception until 10 March 2023. We included randomized controlled trials (RCTs) comparing melatonin and placebo for postoperative outcomes in CS patients. For risk of bias assessment, we used the Cochrane Risk of Bias 2 tool. Continuous variables were pooled as mean difference (MD), and categorical variables were pooled as a risk ratio (RR) with a 95% confidence interval (CI). Results: We included 7 studies with a total of 754 pregnant women scheduled for CS. The melatonin group had a lower pain score (MD = -1.23, 95% CI [-1.94, -0.51], p < 0.001) and longer time to first analgesic request (MD = 60.41 min, 95% CI [45.47, 75.36], p < 0.001) than the placebo group. No difference was found regarding hemoglobin levels, heart rate, mean arterial pressure, total blood loss, or adverse events. Conclusions: Preoperative melatonin may reduce postoperative pain in CS patients without side effects. This research offers a safe and affordable pain management method for this population, which has clinical consequences. Further research is needed to validate these findings and determine the best melatonin dosage and timing.
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Affiliation(s)
- Wardah Albzea
- Faculty of Medicine, Alexandria University, Alexandria 21544, Egypt
| | - Lolwa Almonayea
- Kuwait Institute for Medical Specializations, Kuwait City 12050, Kuwait
| | - Marah Aljassar
- Kuwait Institute for Medical Specializations, Kuwait City 12050, Kuwait
| | - Mousa Atmeh
- Department of Hemto-Oncology, Royal Medical Services, Amman 11855, Jordan
| | - Khaled Al Sadder
- Department of General Surgery, Ministry of Health, Kuwait City 12009, Kuwait
| | - Yousef AlQattan
- Kuwait Institute for Medical Specializations, Kuwait City 12050, Kuwait
| | - Raghad Alhajaji
- Department of Family Medicine, Almagrah Primary Health Care, Ministry of Health, Makkah 11176, Saudi Arabia
| | - Hiba AlNadwi
- King Abdullah Medical City, Makkah 57657, Saudi Arabia
| | - Inaam Alnami
- Senior Registerar Family Medicine, Internal Medicine Department, Security Forces Hospital Program, Makkah 14799, Saudi Arabia
| | - Fatima Alhajaji
- College of Medicine, Umm Alqura University, Makkah 57483, Saudi Arabia
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Mun CJ, Burgess HJ, Sears DD, Parthasarathy S, James D, Altamirano U, Sajith S, Lakhotia A, Fillingim RB, Youngstedt SD. Circadian Rhythm and Pain: a Review of Current Research and Future Implications. CURRENT SLEEP MEDICINE REPORTS 2022. [DOI: 10.1007/s40675-022-00228-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Prabhakar NK, Chadwick AL, Nwaneshiudu C, Aggarwal A, Salmasi V, Lii TR, Hah JM. Management of Postoperative Pain in Patients Following Spine Surgery: A Narrative Review. Int J Gen Med 2022; 15:4535-4549. [PMID: 35528286 PMCID: PMC9075013 DOI: 10.2147/ijgm.s292698] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
Perioperative pain management is a unique challenge in patients undergoing spine surgery due to the increased incidence of both pre-existing chronic pain conditions and chronic postsurgical pain. Peri-operative planning and counseling in spine surgery should involve an interdisciplinary approach that includes consideration of patient-level risk factors, as well as pharmacologic and non-pharmacologic pain management techniques. Consideration of psychological factors and patient focused education as an adjunct to these measures is paramount in developing a personalized perioperative pain management plan. Understanding the currently available body of knowledge surrounding perioperative opioid management, management of opioid use disorder, regional/neuraxial anesthetic techniques, ketamine/lidocaine infusions, non-opioid oral analgesics, and behavioral interventions can be useful in developing a comprehensive, multi-modal treatment plan among patients undergoing spine surgery. Although many of these techniques have proved efficacious in the immediate postoperative period, long-term follow-up is needed to define the impact of such approaches on persistent pain and opioid use. Future techniques involving the use of precision medicine may help identify phenotypic and physiologic characteristics that can identify patients that are most at risk of developing persistent postoperative pain after spine surgery.
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Affiliation(s)
- Nitin K Prabhakar
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Andrea L Chadwick
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Chinwe Nwaneshiudu
- Department of Anesthesiology, Perioperative and Pain Management, Mount Sinai Hospital, Icahn School of Medicine, New York, NY, USA
| | - Anuj Aggarwal
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
| | - Vafi Salmasi
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
| | - Theresa R Lii
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
| | - Jennifer M Hah
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA
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Lim S, Park S, Koyanagi A, Yang JW, Jacob L, Yon DK, Lee SW, Kim MS, Il Shin J, Smith L. Effects of exogenous melatonin supplementation on health outcomes: An umbrella review of meta-analyses based on randomized controlled trials. Pharmacol Res 2022; 176:106052. [PMID: 34999224 DOI: 10.1016/j.phrs.2021.106052] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/23/2021] [Accepted: 12/29/2021] [Indexed: 12/15/2022]
Abstract
Various melatonin supplementations have been developed to improve health outcomes in various clinical conditions. Thus, we sought to evaluate and summarize the effect of melatonin treatments in clinical settings for health outcomes. We searched PubMed/Medline, Embase, and Cochrane Library from inception to 4 February 2021. We included meta-analyses of randomized controlled trials investigating the melatonin intervention for any health outcome. Based on the different effect sizes of each meta-analysis, we calculated random models' standardized mean differences or risk ratios. We observed robust evidence supported by statistical significance with non-considerable heterogeneity between studies for sleep-related problems, cancer, surgical patients, and pregnant women. Patients with sleep disorder, sleep onset latency (SMD 0.33, 95% CI: 0.10 - 0.56, P < 0.01) were significantly improved whereas no clear evidence was shown with sleep efficiency (1.10, 95% CI: -0.26 to 2.45). The first analgesic requirement time (SMD 5.81, 95% CI: 2.57-9.05, P < 0.001) of surgical patients was distinctly improved. Female patients under artificial reproductive technologies had significant increase in the top-quality embryos (SMD 0.53, 95% CI: 0.27 - 0.79, P < 0.001), but no statistically clear evidence was found in the live birth rate (SMD 1.20, 95% CI: 0.83 - 1.72). Survival at one year (RR 1.90, 95% CI: 1.28 - 2.83, P < 0.005) significantly increased with cancer patients. Research on melatonin interventions to treat clinical symptoms and sleep problems among diverse health conditions was identified and provided considerable evidence. Future well-designed randomized clinical trials of high quality and subgroup quantitative analyses are essential.
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Affiliation(s)
- Soojin Lim
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seoyeon Park
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain
| | - Jae Won Yang
- Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Dong Keon Yon
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Seung Won Lee
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Republic of Korea; Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Min Seo Kim
- Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Lee Smith
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
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