The effects of oral melatonin and intravenous midazolame in controlling agitation due to ketamine in emergency department; A randomized clinical trial study

Abstract

Background: Urgent restlessness is a common condition following ketamine anesthesia in the emergency. The aim of this study was to compare the effects of intravenous midazolam, oral melatonin, and placebo in controlling of ketamine-induced agitation in adult patients undergoing minor emergency surgery. Methods: In a randomized clinical trial study, 96 patients in the emergency department who needed ketamine for sedation were divided into three groups of 32 cases. Prior to administration of ketamine, the first group received intravenous midazolam plus oral placebo, the second group received intravenous placebo and oral melatonin, and the third group received oral placebo plus intravenous placebo. The time of re-consciousness and recovery time were determined and compared in the three groups. Findings: The mean score of restlessness was significantly lower in the midazolam and melatonin groups than in the control group (P = 0.020); but there was no difference between the midazolam and melatonin groups (P > 0.999). Conclusion: According to the findings of the study, oral melatonin, as intravenous as midazolam, appears to be effective in reducing ketamine-induced agitation in anesthesia for minor emergency surgeries. © 2020 Isfahan University of Medical Sciences(IUMS). All rights reserved.