Evaluation of Melatonin's Effect on Pain and Blood Loss After Cesarean Section

Study Overview
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Brief Summary
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The purpose of this study is to assess the effect of melatonin on pain and amount of blood loss after cesarean delivery one hundred twenty women with singleton term pregnancy undergoing elective or emergency lower segment cesarean section under spinal anesthesia were included in this study. The patients were randomly allocated to one of three groups of 40 each to receive sublingual 3 mg melatonin or 6 mg melatonin or placebo before spinal of anesthesia . In all patients 20 IU syntocinon which dissolved in 0.5liter of lactated Ringer's solution) at the rate of 500 ml over a 15 minutes period, immediately after delivery of the neonate was infused . Time to first requirement of analgesic supplement, Hemodynamic variables,will be recorded.Patients were instructed preoperatively in the use of the verbal rating scale (VRS) from 0 to 10 (0no pain, 10maximum imaginable pain) for pain assessment. If the VRS exceeded four and the patient requested a supplement analgesic, diclofenac Na supp 100 mg was to be given for post-operative pain relief as needed . For breakthrough pain(VRS >4) if time of administration of diclofenac Na less than 8h,Pethidine 25 mg IV was given. For determination of blood loss ,change in hemoglobin levels, need for additional oxytocics and ,the volume of blood in the suction bottle was measured, blood soaked sponges. Hemoglobin values were determined both before surgery and 12 h following surgery

Conditions
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Post Partum Haemorrhage in Patients Undergoing Cesarean Section

Intervention / Treatment
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* Drug: melatonin 3mg
* Drug: melatonin 6mg
* Drug: placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: pregnant women at term (37-40 wks) gestation scheduled for either elective or emergency lower segment cesarean section Exclusion Criteria: women with any risk factor associated with an increased risk of postpartum hemorrhage were excluded i.e. multiple gestation, antepartum hemorrhage,poly-hydramnios, two or more previous cesarean sections and/or a history of previous rupture uterus current or previous history of significant disease including heart disease, liver, renal disorders ,anemia (Hb8 g%)or known coagulopathy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 42 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: melatonin 3mg<br> | Drug: melatonin 3mg<br>* To receive sublingual 3 mg melatonin before spinal of anesthesia .<br>|
| Active Comparator: melatonin 6mg<br> | Drug: melatonin 6mg<br>* To receive sublingual 6 mg melatonin before spinal of anesthesia .<br>|
| Placebo Comparator: placebo<br> | Drug: placebo<br>* To receive sublingual placebo tablet before spinal of anesthesia .<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to first requirement of analgesic supplement |  | Time to first requirement of analgesic supplement within 24 hours after intratechal injection | 
| amount of blood loss after cesarean delivery |  | during surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| hemodynamic variables |  | 5min before the intrathecal injection,and at 2, 4, 6, 10, 15,20 min after the injection | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Post partum haemorrhage, Cesarean, Pain