Vol. 7, Issue 1, Part A (2025)

Background: Anxiety is characterized by unease, fear, tension, and apprehension, often triggered by internal or external stimuli. The preoperative period commonly induces emotional, cognitive, and physiological stress in surgical patients. Melatonin has shown effectiveness in managing preoperative anxiety, intraoperative cardiovascular stability, and postoperative anxiety and analgesia. Compared to other agents like opioids and beta-blockers, melatonin is easily available, simple to administer, and minimizes risks such as bradycardia and hypotension.

Aim of the Study: To evaluate the effect of melatonin on preoperative anxiety, intraoperative cardiovascular stability, and postoperative anxiety and analgesia. Patients and Methods: A randomized clinical trial was conducted at Al-Hilla General Teaching Hospital between September 1 and November 1, 2021. Seventy-five patients undergoing elective inguinal hernia surgery under general anesthesia were randomized into two groups: Group C (n=40): received low-dose oral multivitamin. Group M (n=35): received 10 mg oral melatonin Medications were administered two hours preoperatively. All patients received standard pre-induction medications including IV paracetamol and ondansetron. Vital signs, pain scores, and Ramsay Sedation Scale were measured preoperatively and at 0, 1, 4, and 8 hours postoperatively.

Results: Demographic variables showed no significant differences between groups. Group M showed significantly lower heart rate, systolic and diastolic blood pressures postoperatively. Melatonin group also had significantly lower pain scores and higher Ramsay sedation scores at all recorded postoperative intervals.

Conclusion: Melatonin is a safe, cost-effective agent that reduces preoperative anxiety, improves postoperative analgesia, and contributes to cardiovascular stability. It can be incorporated into multimodal analgesia protocols to reduce opioid consumption.