الفهرس 
Introduction & Aim of the workOnly 14 pages are availabe for public view
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Abstract
This was a double blinded prospective randomized study, conducted at Minia university hospital on 90 children who were scheduled for adenotonsillectomy; they were divided into 3 groups:
- group M received 0.1mg/kg melatonin syrup in 10 ml apple juice-
-group H received 1 mg/kg hydroxyzine crushed tablets dissolved in 10 ml apple juice
-group C received free 10 ml apple juice as a placebo
The juice was given one hour before anesthesia, all the children were ASA1
The study aimed to compare the effect of melatonin and hydroxyzine in managing pre-operative anxiety, ease of parental separation, pre-operative sedation, and compliance during mask induction, post-operative pain for pediatric patients and time to first analgesic request
All patients were assessed for:
1) Hemodynamics (heart rate, blood pressure, respiratory rate, oxygen saturation) and sedation status that was evaluated by Ramsay Sedation Scale throughout one hour before anesthesia and after premedication (every 15 minutes).
2) Cooperation during the separation from parents for entrance to the operative room that assessed by Ease of Parental Separation Scale.
3) Anxiety level at the operative room at two times prior and during induction of anesthesia, evaluated by modified Yale Pre-operative Anxiety Scale (mYPAS).
4) Post-operative pain that was measured by FLACC scale in young children aged 3-7 years old and numerical rating pain scale (NPS) that was used for children older than 7 years old during the first three hours after recovery from anesthesia
5) Hemodynamics (heart rate, blood pressure, respiratory rate, oxygen saturation) in the first three hours after recovery
6) Time to first analgesic request in the first three hours post operatively
Our results demonstrated that:
Regarding ease of parental separation, there was significant difference between the three groups with hydroxyzine group showing the most cooperation state in children (P =0.001), then melatonin (P =0.01) in comparison to placebo.
Regarding pre-operative anxiety measured by mYPAS before and during induction, hydroxyzine was better than melatonin and placebo, there was highly significant difference (P value< 0.001 ) between the three groups, there was a significant difference between hydroxyzine and placebo(p =0.001) , melatonin and placebo ( p=0.01 pre induction),(p=0.001 at induction), hydroxyzine and melatonin (p=0.04).
Regarding pre and post-operative hemodynamics, there was no statistically significant difference between the three groups
There was no statistically significant difference between melatonin, hydroxyzine premedication and control group regarding pre-operative sedation status
Regarding post-operative pain measured by FLACC and NPS, three was no difference between the three groups
Regarding time to first analgesic request, there was no significant difference between hydroxyzine, melatonin and placebo groups
Recommendations
- Using either oral hydroxyzine or melatonin is beneficial in reducing pre-operative tension and both are available and cheap as a premedication in pediatric patients.
- Making further randomized trials with larger sample sizes is recommended.