LARYNGOSCOPY INTUBATION AND EXTUBATION ARE AFFECTED BY MELATONIN: A PROSPECTIVE STUDY
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 3209-3216
AbstractAim and objectives: Hypertension and increased heart rate are prevalent during laryngoscopy and tracheal intubation. Acute LV failure, dysrhythmias, IC haemorrhage, pulmonary edoema and myocardial infarction are all possible complications. Patients with hypertension had a heightened pressor response, despite being preoperatively normalized with anti-hypertensive medication. The purpose of this research is to see if melatonin is more effective than a placebo at reducing the Haemodynamic reactions to laryngoscopy and endotracheal intubation. Research into the effects of melatonin on extubation response and intraoperative hemostasis is also a goal.
Materials and Methods: This study took place between June 2020 and May 2022 at Public Sector Tertiary care center and the Government Ear, Nose, and Throat Hospital. There were a total of 60 participants in the study. They split up into pairs. Melatonin 6 mg capsules (Group M) and a placebo (Vitamin D3) were given to Group C, both to be taken 120 minutes before to surgery.
Results: The melatonin group had a considerably lower increase in HR compared to the control group during laryngoscopy and intubation (P0.0029). The melatonin group also had considerably decreased heart rate variability during and after extubation compared to the placebo group. After induction, during laryngoscopy and intubation, and for the first 10 minutes after tracheal intubation, systolic blood pressure was considerably lower in the melatonin group. Systolic blood pressure was considerably lower in the melatonin group after surgery. Compared to the placebo group, the SBP of those receiving melatonin prior to, during, and after extubation dropped dramatically. The melatonin group had lower diastolic blood pressure than the placebo group throughout laryngoscopy and intubation, as well as after 1 minute, 5 minutes, and 10 minutes post-intubation. The intraoperative DBP in the melatonin group was substantially lower. DBP was likewise considerably lower in the melatonin group after extubation. As a result, the melatonin group had considerably lower mean arterial pressure (MAP) during the intraoperative time. There was a huge discrepancy
between the groups during the extubation process and immediately afterward.
Conclusion: The results of the study show that the hemodynamic reactions to laryngoscopy, intubation, and extubation can be reduced by giving the patient 6 milligrammes of exogenous melatonin orally 120 minutes before intubation. In addition, it aids in keeping intraoperative hemodynamics steady.
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