Effect of Melatonin on Postoperative Pain after Simple Nephrectomy: A Randomized Double-Blinded Controlled Study | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 99, Volume 100, Issue 1, July 2025, Page 3231-3240 PDF (669.19 K) | ||||
| DOI: 10.21608/ejhm.2025.443485 | ||||
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| Abstract | ||||
| Introduction: Simple nephrectomy (SN) refers to resecting the kidney enveloped by Gerota’s fascia. However, SN is associated with moderate to severe postoperative pain. This pain is not always adequately controlled with opioids and they are associated with side effects such as sedation, nausea, pruritus, vomiting and constipation. Melatonin is a hormone produced by pineal gland within brain. Recent research has highlighted multiple advantages of its perioperative administration, such as enhanced postoperative recovery quality, alleviation of depressive symptoms, and decreased pain scores. Aim: To assess the effectiveness of melatonin in controlling postoperative pain after SN. Patients and Methods: This randomized, double-blind, controlled study enrolled 45patients scheduled for SN. Participants were randomly allocated into two groups: Group M (n=20) which received 4 mg of prolonged-release oral melatonin at 8 PM the evening prior to surgery and again two hours before procedure, and group C(n=20) which received placebo tablets. Postoperative pain was evaluated using VAS score at different time points. Additionally, first analgesic request time, anxiety scores, total analgesic consumption during first 24 hours, case satisfaction and incidence of adverse effects were documented. Results: VAS scores at 2 and 4 hours postoperatively were lower in Group M, with statistical significance noted at both intervals (P=0.004 and P=0.03 respectively). The duration for first rescue analgesia was markedly prolonged in Group M (P< 0.001), and total morphine consumption within first 24 hours was substantially reduced in this group (P< 0.001). Conclusion: Melatonin administration in cases undergoing SN was associated with a longer time to first rescue analgesia request, reduction in total morphine consumption, and lower anxiety levels. | ||||
| Keywords | ||||
| Melatonin; Simple Nephrectomy; Postoperative Analgesia | ||||
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