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Perioperative Anxiolysis and Analgesic Effect after Premedication with Melatonin and Pregabalin in Total Hip Arthroplasty under Spinal Anaesthesia: A Prospective Comparative Trial

BACKGROUND: Preoperative anxiety plays a critical role in post-operative pain response and other outcomes. Melatonin is a naturally secreted hormone which has anxiolytic, sedative, and analgesic properties. Pregabalin, analogue of gabapentin which has property of anxiolytic and analgesic effects. MA...

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Autores principales: Mishra, Akash, Srivastava, Vinod Kumar, Prakash, Ravi, Mishra, Neel Kamal, Agarwal, Jyotsna, Kabi, Shruti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492595/
https://www.ncbi.nlm.nih.gov/pubmed/37694243
http://dx.doi.org/10.4103/abr.abr_323_22
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author Mishra, Akash
Srivastava, Vinod Kumar
Prakash, Ravi
Mishra, Neel Kamal
Agarwal, Jyotsna
Kabi, Shruti
author_facet Mishra, Akash
Srivastava, Vinod Kumar
Prakash, Ravi
Mishra, Neel Kamal
Agarwal, Jyotsna
Kabi, Shruti
author_sort Mishra, Akash
collection PubMed
description BACKGROUND: Preoperative anxiety plays a critical role in post-operative pain response and other outcomes. Melatonin is a naturally secreted hormone which has anxiolytic, sedative, and analgesic properties. Pregabalin, analogue of gabapentin which has property of anxiolytic and analgesic effects. MATERIALS AND METHODS: Total 96 patients undergoing total hip arthroplasty, divided into 3 groups of 32 each and were given placebo (group I), melatonin 6 mg (group II), and pregabalin 150 mg (group III). Anxiety level, postoperative pain score, sedation level and duration as well as characteristics of spinal anaesthesia were assessed with other vital parameters. RESULTS: Group I showed an increment in the anxiety score from baseline whereas in group II and group III, there was a decline in pre-operative anxiety score from baseline at all the periods of observation and more significantly in group III. Visual analogue scale (VAS) score and total dose of rescue analgesia were highest in group I, but group II and group III were comparable to each other. However, the durations of spinal anaesthesia and motor blockade showed a statistically significant difference with maximum duration in group III followed by II and then I. The level of sedation among the three groups were comparable at all the periods of observation. CONCLUSIONS: Pregabalin was found better for perioperative anxiolysis, post-operative analgesia and for prolongation of duration of spinal anaesthesia when compared to melatonin.
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spelling pubmed-104925952023-09-10 Perioperative Anxiolysis and Analgesic Effect after Premedication with Melatonin and Pregabalin in Total Hip Arthroplasty under Spinal Anaesthesia: A Prospective Comparative Trial Mishra, Akash Srivastava, Vinod Kumar Prakash, Ravi Mishra, Neel Kamal Agarwal, Jyotsna Kabi, Shruti Adv Biomed Res Original Article BACKGROUND: Preoperative anxiety plays a critical role in post-operative pain response and other outcomes. Melatonin is a naturally secreted hormone which has anxiolytic, sedative, and analgesic properties. Pregabalin, analogue of gabapentin which has property of anxiolytic and analgesic effects. MATERIALS AND METHODS: Total 96 patients undergoing total hip arthroplasty, divided into 3 groups of 32 each and were given placebo (group I), melatonin 6 mg (group II), and pregabalin 150 mg (group III). Anxiety level, postoperative pain score, sedation level and duration as well as characteristics of spinal anaesthesia were assessed with other vital parameters. RESULTS: Group I showed an increment in the anxiety score from baseline whereas in group II and group III, there was a decline in pre-operative anxiety score from baseline at all the periods of observation and more significantly in group III. Visual analogue scale (VAS) score and total dose of rescue analgesia were highest in group I, but group II and group III were comparable to each other. However, the durations of spinal anaesthesia and motor blockade showed a statistically significant difference with maximum duration in group III followed by II and then I. The level of sedation among the three groups were comparable at all the periods of observation. CONCLUSIONS: Pregabalin was found better for perioperative anxiolysis, post-operative analgesia and for prolongation of duration of spinal anaesthesia when compared to melatonin. Wolters Kluwer - Medknow 2023-07-20 /pmc/articles/PMC10492595/ /pubmed/37694243 http://dx.doi.org/10.4103/abr.abr_323_22 Text en Copyright: © 2023 Advanced Biomedical Research https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Mishra, Akash
Srivastava, Vinod Kumar
Prakash, Ravi
Mishra, Neel Kamal
Agarwal, Jyotsna
Kabi, Shruti
Perioperative Anxiolysis and Analgesic Effect after Premedication with Melatonin and Pregabalin in Total Hip Arthroplasty under Spinal Anaesthesia: A Prospective Comparative Trial
title Perioperative Anxiolysis and Analgesic Effect after Premedication with Melatonin and Pregabalin in Total Hip Arthroplasty under Spinal Anaesthesia: A Prospective Comparative Trial
title_full Perioperative Anxiolysis and Analgesic Effect after Premedication with Melatonin and Pregabalin in Total Hip Arthroplasty under Spinal Anaesthesia: A Prospective Comparative Trial
title_fullStr Perioperative Anxiolysis and Analgesic Effect after Premedication with Melatonin and Pregabalin in Total Hip Arthroplasty under Spinal Anaesthesia: A Prospective Comparative Trial
title_full_unstemmed Perioperative Anxiolysis and Analgesic Effect after Premedication with Melatonin and Pregabalin in Total Hip Arthroplasty under Spinal Anaesthesia: A Prospective Comparative Trial
title_short Perioperative Anxiolysis and Analgesic Effect after Premedication with Melatonin and Pregabalin in Total Hip Arthroplasty under Spinal Anaesthesia: A Prospective Comparative Trial
title_sort perioperative anxiolysis and analgesic effect after premedication with melatonin and pregabalin in total hip arthroplasty under spinal anaesthesia: a prospective comparative trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492595/
https://www.ncbi.nlm.nih.gov/pubmed/37694243
http://dx.doi.org/10.4103/abr.abr_323_22
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