Effect of melatonin on duration of delirium in organophosphorus compound poisoning patients: A double-blind randomised placebo controlled trial
Background and Aims: Organophosphate compound poisoning (OPCP) is associated with high incidence of delirium. Melatonin has been tried in the treatment of delirium and has shown a beneficial effect in OPCP. This study was conducted to know the effect of melatonin on duration of delirium and recovery...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=11;spage=814;epage=820;aulast=Vijayakumar |
| _version_ | 1828826953870737408 |
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| author | H N Vijayakumar K Ramya Devika Rani Duggappa K M Veeranna Gowda K Sudheesh S S Nethra R S Raghavendra Rao |
| author_facet | H N Vijayakumar K Ramya Devika Rani Duggappa K M Veeranna Gowda K Sudheesh S S Nethra R S Raghavendra Rao |
| author_sort | H N Vijayakumar |
| collection | DOAJ |
| description | Background and Aims: Organophosphate compound poisoning (OPCP) is associated with high incidence of delirium. Melatonin has been tried in the treatment of delirium and has shown a beneficial effect in OPCP. This study was conducted to know the effect of melatonin on duration of delirium and recovery profile in OPCP patients. Methods: Double-blind randomised placebo control trial in which 56 patients of OPCP confirmed by history and syndrome of OPCP with low plasma pseudocholinesterase, aged >18 years and weighing between 50 and 100 kg, and Acute Physiology and Chronic Health Evaluation II score of <20 were studied. Group M (n = 26) received tablet melatonin 3 mg and Group C (n = 30) received placebo tablet at 9 PM, every night throughout the Intensive Care Unit (ICU) stay. Delirium was assessed using the Confusion Assessment Method for ICU, thrice a day. Sedation was provided with injection midazolam, fentanyl and lorazepam. Duration of mechanical ventilation, vital parameters, ICU stay, sedative and atropine requirement, were recorded. Results: The time taken to be delirium free was significantly lower in Group M (6 ± 2.92 days) compared to Group C (9.05 ± 2.75 days) (P = 0.001) and prevalence of delirium was significantly decreased in Group M compared to Group C from day 3 onwards. The requirement of midazolam (Group M - 2.98 ± 4.99 mg/day, Group C - 9.68 ± 9.17 mg/day, P < 0.001) and fentanyl (Group M - 94.09 ± 170.05 μg/day, Group C - 189.33 ± 156.38 μg/day, P = 0.03) decreased significantly in Group M. There was no significant difference in the average atropine consumption (P = 0.27), duration of mechanical ventilation (P = 0.26), ICU stay (P = 0.21) and the number of patients requiring mechanical ventilation (P = 0.50). Conclusion: Orally given melatonin in organophosphate compound poisoning patients reduces the duration of delirium and the requirement of sedation and analgesia. |
| first_indexed | 2024-12-12T14:49:55Z |
| format | Article |
| id | doaj.art-bae18822eddf43b5aaea7701b764c827 |
| institution | Directory Open Access Journal |
| issn | 0019-5049 0976-2817 |
| language | English |
| last_indexed | 2024-12-12T14:49:55Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-bae18822eddf43b5aaea7701b764c8272022-12-22T00:21:01ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172016-01-01601181482010.4103/0019-5049.193664Effect of melatonin on duration of delirium in organophosphorus compound poisoning patients: A double-blind randomised placebo controlled trialH N VijayakumarK RamyaDevika Rani DuggappaK M Veeranna GowdaK SudheeshS S NethraR S Raghavendra RaoBackground and Aims: Organophosphate compound poisoning (OPCP) is associated with high incidence of delirium. Melatonin has been tried in the treatment of delirium and has shown a beneficial effect in OPCP. This study was conducted to know the effect of melatonin on duration of delirium and recovery profile in OPCP patients. Methods: Double-blind randomised placebo control trial in which 56 patients of OPCP confirmed by history and syndrome of OPCP with low plasma pseudocholinesterase, aged >18 years and weighing between 50 and 100 kg, and Acute Physiology and Chronic Health Evaluation II score of <20 were studied. Group M (n = 26) received tablet melatonin 3 mg and Group C (n = 30) received placebo tablet at 9 PM, every night throughout the Intensive Care Unit (ICU) stay. Delirium was assessed using the Confusion Assessment Method for ICU, thrice a day. Sedation was provided with injection midazolam, fentanyl and lorazepam. Duration of mechanical ventilation, vital parameters, ICU stay, sedative and atropine requirement, were recorded. Results: The time taken to be delirium free was significantly lower in Group M (6 ± 2.92 days) compared to Group C (9.05 ± 2.75 days) (P = 0.001) and prevalence of delirium was significantly decreased in Group M compared to Group C from day 3 onwards. The requirement of midazolam (Group M - 2.98 ± 4.99 mg/day, Group C - 9.68 ± 9.17 mg/day, P < 0.001) and fentanyl (Group M - 94.09 ± 170.05 μg/day, Group C - 189.33 ± 156.38 μg/day, P = 0.03) decreased significantly in Group M. There was no significant difference in the average atropine consumption (P = 0.27), duration of mechanical ventilation (P = 0.26), ICU stay (P = 0.21) and the number of patients requiring mechanical ventilation (P = 0.50). Conclusion: Orally given melatonin in organophosphate compound poisoning patients reduces the duration of delirium and the requirement of sedation and analgesia.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=11;spage=814;epage=820;aulast=VijayakumarDeliriummelatoninorganophosphorus compound poisoningsedation |
| spellingShingle | H N Vijayakumar K Ramya Devika Rani Duggappa K M Veeranna Gowda K Sudheesh S S Nethra R S Raghavendra Rao Effect of melatonin on duration of delirium in organophosphorus compound poisoning patients: A double-blind randomised placebo controlled trial Indian Journal of Anaesthesia Delirium melatonin organophosphorus compound poisoning sedation |
| title | Effect of melatonin on duration of delirium in organophosphorus compound poisoning patients: A double-blind randomised placebo controlled trial |
| title_full | Effect of melatonin on duration of delirium in organophosphorus compound poisoning patients: A double-blind randomised placebo controlled trial |
| title_fullStr | Effect of melatonin on duration of delirium in organophosphorus compound poisoning patients: A double-blind randomised placebo controlled trial |
| title_full_unstemmed | Effect of melatonin on duration of delirium in organophosphorus compound poisoning patients: A double-blind randomised placebo controlled trial |
| title_short | Effect of melatonin on duration of delirium in organophosphorus compound poisoning patients: A double-blind randomised placebo controlled trial |
| title_sort | effect of melatonin on duration of delirium in organophosphorus compound poisoning patients a double blind randomised placebo controlled trial |
| topic | Delirium melatonin organophosphorus compound poisoning sedation |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=11;spage=814;epage=820;aulast=Vijayakumar |
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