Investigating the Influence of Melatonin on the Respiratory Rate, Heart Rate and Oxygen Saturation in Paediatric Surgical Care: A Randomized Double-Blinding Trial
Haider Muhy AL bareh, Mohammed Jawad Kadhim Alkidsawi,
Hussein Ali Hussein, Majid Fakhir Alhamaidah,
Ammar Hoom Mahdi, Mohamed Kahloul
Melatonin, an endogenous hormone the pineal gland produces, is recognized for its sleep-inducing, anxiety-reducing, and pain-relieving characteristics. It has been used as a premedication in pediatric patients to reduce preoperative anxiety and enhance the quality of anesthesia induction. Nevertheless, the impact of melatonin on the respiratory rate (RR) and heart rate (HR) of children undergoing elective surgeries has not been well investigated. This study is a randomized, double-blind trial aiming to assess the influence of melatonin on oxygen saturation, respiratory, and heart rate in the pediatric age group undergoing elective surgeries. The objective is to investigate whether melatonin administration before surgery can benefit physiological parameters before the induction of anesthesia. This study was conducted at a specialized pediatric hospital using a randomized and double-blind trial. A sample of 126 children, ranging from 4 to 14 years, with ASA physical status I or II, who were scheduled for elective surgery under general anesthesia, were included in the study. They were randomly divided into M4 (n = 63) and M2(n=63). Children in the M4 and M2 groups were administered oral syrup melatonin at 0.4 and 0.2 mg/kg with a maximum dose of 10 mg. Administer the medication 60-90 minutes before induction of anesthesia; all patients recorded the SPO2, RR, and HR before premedication and before anesthesia induction. The two study groups were comparable in terms of mean age, weight, and sex; before induction anesthesia, the HR mean recorded 100.65 ± 14.66 BPM in the M 4 group, which was lower than the mean HR in the M 2 group (104.67 ± 18.39 BPM). The two groups had no statistically significant difference according to HR (p=0.178). The mean RR prior to induction of anesthesia recorded 25.71 ± 4.53 breaths per minute in the M 4 group, which was lower than the mean RR in the M 2 group (26.7 ± 4.71 BPM). The two groups had no statistically significant difference according to RR (p=0.234). Before induction of anesthesia, the mean SPO2 was recorded 99.13 ± 0.71 % in the melatonin 0.4 mg/kg group, which was higher than the mean SPO2 in the melatonin 0.2mg/kg group (98.97 ± 0.59 %). There was no statistically significant difference between the two groups according to SPO2 (p=0.175). The administration of melatonin at a dosage of 0.4 mg/kg was found to be more efficacious than M2 in reducing heart rate prior to the induction of anesthesia, with no statistical significance. Melatonin can be used safely as a premedication in children without inducing notable respiratory depression. No patient's SpO2 fell below 98 % prior to induction of anesthesia.
Keywords: Melatonin, Pediatric, Stress surgery, Respiratory rate, Heart rate
