Efficacy of preoperative melatonin and ramelteon (melatonin agonist) therapy on dose requirement of propofol for induction of general anaesthesia: A comparative prospective study

Authors : Kuntal Roy, Kuntal Roy, Manas Ranjan Panigrahi, Manas Ranjan Panigrahi, Bhabananda Mukhopadhyay, Bhabananda Mukhopadhyay, Santanu Bisak, Santanu Bisak, Binay Kumar , Binay Kumar

DOI : 10.18231/j.ijca.2020.030

Volume : 7

Issue : 1

Year : 2020

Page No : 172-176

Introduction: General anesthesia is a medically induced coma with loss of protective reflexes resulting
from the administration of one or more general anesthetic agents Our study is to compare the role and
efficacy of preoperative oral Melatonin, Ramelteon, and Midazolam therapy on the dose requirement of
induction agent (Propofol).
Materials and Methods: Were divided into Case and Control Group. Case group of people were given
Oral Melatonin (6mg)/Ramelteon (8mg) as premedication 2 to 3 hours before induction in OT and the
control group were given oral Midazolam (5mg). After checking all the parameters, the induction process
Total number of 60 people was randomly selected from ASA grade I & grade II, aged between 20 to 50
years, started with injection Propofol slowly in intravenous route and subsequently the BIS level up 60
was noted. After complete reversal of General Anesthesia, post-operative sedation level of the patient was
measured using Ramsey sedation scale.
Result: Melatonin and Ramelteon shows significant reduction in preoperative anxiety state of the patient in
comparison to Midazolam, measured by Hamilton Anxiety rating scale. The sedation status was measured
by Ramsey Sedation Scale for each drug and it shows no significant difference between the drugs.
Conclusion: Considering absolute values and statistical values, all three drugs are potent premedication
in general anesthesia. Among them, Melatonin is most potent in reducing the induction dose of injection
Propofol. Ramelteon is also effective in reducing induction dose of Propofol. Along with, both are potent
anxiolytic agent in pre-operative state.

Keywords: General anesthesia, Melatonin, Ramelteon, Propofol, Post-operative sedation.


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