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A Comparative Study between Melatonin and Midazolam as Premedication for Preoperative Anxiety in Patients Undergoing Cataract Surgery Under General Anesthesia: A Clinical Trial
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Abstract
Introduction
Preoperative anxiety is a common concern among surgical patients and a key focus for anesthesiologists. Premedication, such as melatonin—an emerging option for sedation before cataract surgery—and midazolam, a routinely used benzodiazepine, play a vital role in managing anxiety and ensuring effective anesthetic care. This study aimed to compare the effects of melatonin and midazolam on the anxiety of cataract surgery candidates under general anesthesia.
Methods
This study included 40 patients scheduled for cataract surgery under general anesthesia at a surgical center in Birjand, Iran. Participants were randomly divided into two groups: one received 0.1 mg/kg oral melatonin, and the other received 70–80 µg/kg IV midazolam as premedication. Anesthesia was induced uniformly with fentanyl (1 µg/kg), propofol (2 mg/kg), and atracurium (0.5 mg/kg). Anxiety levels were assessed using the Beck Anxiety Inventory at two-time points: before premedication (baseline) and 1.5 hours after administration (30 minutes pre-surgery).
Results
There was no significant difference in the comparison of the average anxiety score after and before the premedication in the two investigated groups. The average anxiety score after the premedication in the midazolam group was not significantly different compared to before the premedication)P=0.817(, but the average anxiety score in the melatonin group after the premedication was significantly reduced compared to before the premedication (P<0.001).
Discussion
Both melatonin and midazolam similarly reduced preoperative anxiety in cataract surgery patients, with melatonin potentially offering a safer profile. Further studies could explore its wider use as an alternative to benzodiazepines.
Conclusion
Melatonin may serve as a suitable alternative to midazolam for reducing preoperative anxiety. Given its better safety profile, further investigation of its broader applications is recommended.
