The Efficacy of Melatonin and Clonidine in Preventing Emergence Delirium in the Elderly Undergoing Orthopedic Surgery, Neurosurgery, and General Surgery: A Placebo-controlled Randomized Clinical Trial

Background: Emergence delirium (ED) is a complication after surgeries due to general anesthesia. Objectives: This study aimed evaluate the efficacy of melatonin and clonidine, which are hypothesized have curative effect on ED. Methods: randomized, placebo-controlled, double-blind, three-way parallel clinical trial was performed in Imam Reza Hospital Birjand, Iran 2019 - 2020 who were selected using convenience sampling. The inclusion criteria age > 65 years preoperative Abbreviated Mental Test (AMT) score ≥ 8. exclusion suffering from any chronic diseases. Participants divided into 3 groups: Placebo, groups received placebo, 100 μg 5 mg melatonin, respectively. A first dose administered at bedtime before surgery, second 90 minutes procedure. An AMT Mini-mental State Examination (MMSE) determine Results: included 150 patients with mean standard deviation 74.6 ± 6.8 years. According MMSE, there no significant difference level ED between first, second, third days surgery (P 0.05). levels clonidine lower than placebo group. not significantly correlated gender, age, type surgery. associated postoperative bleeding electrolyte disturbance < Conclusions: Melatonin did affect occurrence elderly undergoing but these medications could slightly reduce their occurrence.