Melatonin for Post Operative Delirium Prevention in Elderly Patients

The Impact of Melatonin on the Postoperative Delirium in Geriatric Patients After Colorectal Surgeries. A Randomised Placebo-controlled Trial

The present study will evaluate the role of melatonin prophylaxis in delirium prevention in elderly patients undergoing colorectal procedures.

This study is a prospective randomised double-blind placebo-controlled trial. Patients who meet the criteria for inclusion/exclusion will be evaluated. Melatonin tablets will be administered as a premedication to patients in the melatonin group. Patients in the control group will be given placebo tablets as a premedication. Fentanyl 1ug/kg and propofol 1-2 mg/kg will be used to induce anaesthesia. Atracurium 0.5 mg/kg will be used for the facilitation of endotracheal intubation. Isoflurane will be used to maintain anaesthesia and the depth of anaesthesia will be adjusted by a Bispectral index monitor. Postoperatively, the patients will be monitored for the development of delirium.

The patients will be given 5 mg melatonin the night before surgery, 12 hours before the scheduled time of surgery, followed by another 5 mg melatonin two hours before surgery.

The patients will be premedicated with placebo tablets, which will be administered at the same times as the melatonin group.

The patients will be given 5 mg melatonin the night before surgery, 12 hours before the scheduled time of surgery, followed by another 5 mg melatonin two hours before surgery.

The patients will be premedicated with placebo tablets, which will be administered at the same times as the melatonin group.

Nursing delirium - screening score. It scores five items,Each item is rated from 0 to 2 where 0, absent; 1, mild; 2, severe. A score ≥ 2 is considered to have delirium.

Ramsay sedation score from 1 to 6. score 2 to 4 is acceptable sedation. Score 5 or 6 is excessive sedation

Pain Assessment in Advanced Dementia Scale from 0 to 10 . score 1 to 3=mild pain; 4 to 6=moderate pain; 7-to 10=severe pain.

Inclusion Criteria: American Society of Anaesthesiologists (ASA) I to III physical status Elective colorectal procedures Exclusion Criteria: Allergy to the research drugs, Patients who have vision or hearing impairment History of cerebral disorders Uncorrected acid-base, fluid, and electrolyte abnormalities History of central nervous system function affecting drugs. Chronic sedative-hypnotic administration at least one month prior to surgery Alcohol abuse Patients with recorded preoperative nursing delirium screening score ≥ 2.