The effects of melatonin on anxiety and pain scores of patients, intraocular pressure, and operating conditions during cataract surgery under topical anesthesia

AIMS To evaluate the effects of melatonin premedication on anxiety and pain scores of patients, operating conditions, and intraocular pressure during cataract surgery under topical anesthesia. MATERIALS AND METHODS Sixty patients were randomly assigned to receive either sublingual melatonin 3 mg or placebo 60 min before surgery. Verbal anxiety scores and verbal pain scores, heart rate, systolic and diastolic blood pressure, intraocular pressure, and quality of operating conditions were recorded. RESULTS Melatonin significantly reduced the anxiety scores (median, interquartile range) from 5 and 5-3 to 3 and 2-4 after premedication and to 3 and 2-3 during surgery and to 0 and 0-1 postoperatively before discharge from the recovery room. There were significant differences between two groups in anxiety scores after premedication (95% CI 3-3.5; P = 0.023), intraoperatively (95% CI 2.5-3.5; P = 0.007), and postoperatively (95% CI 0.5-1; P = 0.007). The surgeon reported better quality of operating conditions in the melatonin group (P = 0.001). No significant difference in intraoperative and postoperative pain scores, intraocular pressure, heart rate, and systolic and diastolic blood pressure between two groups was recorded. CONCLUSION Sublingual melatonin premedication for patients undergoing cataract surgery under topical anesthesia reduced the anxiety scores in patients and provided excellent operating conditions.