Methods | Randomized, double‐blind, placebo‐controlled study Location: Saudi Arabia Study design: parallel, 3‐armed |
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Participants | A total of 75 patients randomized 75 patients completed: 25 in melatonin group, 25 in placebo group, 25 in midazolam group Age: melatonin 29.6 (22 to 43), placebo 30.1 (22 to 40), midazolam 29.5 (19 to 44) Gender (M/F) in %: melatonin (0/100), placebo (0/100), midazolam (0/100) ASA class: I Type of surgery: gynaecological laparoscopic procedures Type of anaesthesia: general Baseline (anxiety, pain) described: yes, no |
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Interventions | Melatonin: 5 mg Placebo: saline Midazolam: 15 mg Administration route: sublingual Time of administration: approximately 100 min preoperatively |
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Outcomes | 1. Anxiety assessed by Visual Analogue Scale (0 to 100) (pre‐ and postoperative) 2. Orientation score (0 to 2) 3. Sedation score (0 to 4) 4. Psychomotor activity measured by The Digit‐symbol Substitution Test and Trieger dot test 5. Amnesia by showing line diagrams 6. Postoperative pain assessed by Visual Analogue Scale (0 to 100) and morphine consumption (mg) |
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Notes | Sample size calculation: described Author contacted by e‐mail on 9 August 2013 to clarify unspecified issues ‐ e‐mail returned = delivery failure |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Quote: "... allocated randomly..." (page 876) (Naguib 1999) |
Allocation concealment (selection bias) | Unclear risk | No information provided |
Incomplete outcome data (attrition bias) All outcomes | Low risk | No reported dropouts or missing data |
Selective reporting (reporting bias) | Unclear risk | Study protocol not available |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | Quote: "... marked only with a coded label to maintain the double‐blind nature of the study" (page 876) |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Quote: "The same psychologist blinded to group assignment performed all test scoring and calculations" (page 876) |