The Effects Of Melatonin Versus Midazolam On Postoperative Behavioral Disturbances In Pediatric Patients Undergoing General Anesthesia

Objective: To investigate the effect of oral melatonin and midazolam on postoperative behavioral disturbances and to observe the sedative effect of melatonin.Methods: Patients,aged2-6 yrs.,ASA I-II,scheduled to undergo elective adenotonsillectomy or adenoidecomy under sevoflurane general anesthesia were randomly assigned to melatonin,midazolam or placebo group to receive oral melatonin 0.5 mg/kg,midazolam 0.5 mg/kg or 5ml sweet liquid respectively 30 min approximately before induction.The child's sedation level was assessed before the premedication and when entering the operating room,using the Ramsay sedation scale.PAED scale was used to assess EA/ED during the period in PACU.CHEOPS was used to assess children's pain.And the duration of operation,extubation,PACU stay and adverse events were also recorded.PHBQ,which was administered via telephone to parents,was applied to investigate the child's behavioral changes on postoperative days 1,7,30.Results: 163 patients were enrolled.The incidence of EA/ED was significant lower in melatonin and midazolam group than placebo group(p<0.05),but no significant difference was observed between melatonin and midazolam group(p>0.05).There was no significant difference in the incidence of NPOBC on POD 1,7,30(p>0.05).Higher sedation level was observed in melatonin and midazolam group after medication(p<0.05).What's more,the sedation level in midazolam group was higher than that in melatonin group(p<0.05).Conclusions: We conclude that oral melatonin 0.5 mg/kg or oral midazolam 0.5mg/kg 30 min approximately before induction can reduce the incidence of EA/ED.But melatonin and midazolam cannot significantly reduce the incidence of NPOBC on POD 1,7,30.Oral melatonin may provide sedative effect but not as effective as midazolam.