Use of Melatonin for Preventing POCD in Transurethral Prostate Resection Under Spinal Anesthesia

NCT ID: NCT03966950

Last Updated: 2019-05-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-06-26

Study Completion Date

2021-11-26

Brief Summary

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This study aims to evaluate the possible effect of melatonin on prevention of cognitive dysfunction in the postoperative period of elderly patients undergoing transurethral resection of the prostate (TURP) under spinal anesthesia

Detailed Description

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TURP is the most common surgical procedure performed on male patients over 60 years of age to treat benign prostatic hyperplasia.

One of the concerns, since it compromises the quality of life, is postoperative cognitive dysfunction. It can be due to TURP Syndrome or to other causes, like changing the routine and circadian rhythm for patients with more susceptibility.

The investigators postulate that melatonin premedication and use during the perioperative period could avoid cognitive impairment in patients undergoing TURP surgery that didn't develop major complications, like TURP Syndrome.

Since anesthestic technic could also influence the outcome of POCD, only patients undergoing spinal anesthesia were included in the study,

Conditions

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Melatonin Cognitive Dysfunction Postoperative Complications Prostate Hyperplasia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

randomized, parallel assignment
Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
triple masking

Study Groups

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melatonin group

for the melatonin group, 10 mg of melatonin will be taken per os in the evening before the surgery and in the immediate postoperative night and the first and second postoperative days.

Group Type EXPERIMENTAL

melatonin

Intervention Type DIETARY_SUPPLEMENT

melatonin 10 mg per os in the preoperative night and the immediate postoperative night and the first and second postoperative nights.

placebo group

For the placebo group, placebo will be administered per os in the evening before the surgery and in the immediate postoperative night and the first and second postoperative days.

Group Type PLACEBO_COMPARATOR

Placebo oral tablet

Intervention Type DRUG

placebo taken per os in the preoperative night and the immediate postoperative night and the first and second postoperative nights

Interventions

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melatonin

melatonin 10 mg per os in the preoperative night and the immediate postoperative night and the first and second postoperative nights.

Intervention Type DIETARY_SUPPLEMENT

Placebo oral tablet

placebo taken per os in the preoperative night and the immediate postoperative night and the first and second postoperative nights

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

patients over 60 years who underwent elective surgery for transurethral prostate ressection under spinal anesthesia.

MME \> 18 (for those who had less than 4 years of formal education ) or MME \> 23 (for those with 4 or more years of formal education)

Exclusion Criteria

MME \< 18 (for those who had less than 4 years of formal eduaction) or 23 (for those with 4 years or more of formal eduacation); History of cancer, brain disease, seizure, Parkinson, dementia, hallucination or any disorder that affects cognition before the surgery.

Lack of proficiency in portuguese mild or severe hearing loss or blindness.
Minimum Eligible Age

60 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Sao Paulo

OTHER

Sponsor Role lead

Responsible Party

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Maria José Carvalho Carmona

professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Maria JC Carmona, PHD

Role: PRINCIPAL_INVESTIGATOR

Associate Professor

Locations

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Hospital das Clinicas

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Maria JC Carmona, PHD

Role: CONTACT

+5511996450293

Cristiane Tavares, MD

Role: CONTACT

+5511983039765

Facility Contacts

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Maria JC Carmona, PhD

Role: primary

+5511986613950

Cristiane Tavares, MD

Role: backup

+5511983039765

References

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Kotekar N, Kuruvilla CS, Murthy V. Post-operative cognitive dysfunction in the elderly: A prospective clinical study. Indian J Anaesth. 2014 May;58(3):263-8. doi: 10.4103/0019-5049.135034.

Reference Type RESULT
PMID: 25024467 (View on PubMed)

Kotekar N, Shenkar A, Nagaraj R. Postoperative cognitive dysfunction - current preventive strategies. Clin Interv Aging. 2018 Nov 8;13:2267-2273. doi: 10.2147/CIA.S133896. eCollection 2018.

Reference Type RESULT
PMID: 30519008 (View on PubMed)

Segal-Gidan F. Postoperative confusion in older adults. JAAPA. 2017 Apr;30(4):12-16. doi: 10.1097/01.JAA.0000513345.29384.39.

Reference Type RESULT
PMID: 28282301 (View on PubMed)

Strom C, Rasmussen LS, Sieber FE. Should general anaesthesia be avoided in the elderly? Anaesthesia. 2014 Jan;69 Suppl 1(Suppl 1):35-44. doi: 10.1111/anae.12493.

Reference Type RESULT
PMID: 24303859 (View on PubMed)

Rasmussen LS, Johnson T, Kuipers HM, Kristensen D, Siersma VD, Vila P, Jolles J, Papaioannou A, Abildstrom H, Silverstein JH, Bonal JA, Raeder J, Nielsen IK, Korttila K, Munoz L, Dodds C, Hanning CD, Moller JT; ISPOCD2(International Study of Postoperative Cognitive Dysfunction) Investigators. Does anaesthesia cause postoperative cognitive dysfunction? A randomised study of regional versus general anaesthesia in 438 elderly patients. Acta Anaesthesiol Scand. 2003 Mar;47(3):260-6. doi: 10.1034/j.1399-6576.2003.00057.x.

Reference Type RESULT
PMID: 12648190 (View on PubMed)

Becher KF. [Delirium in geriatric urology patients]. Urologe A. 2019 Apr;58(4):398-402. doi: 10.1007/s00120-019-0887-4. German.

Reference Type RESULT
PMID: 30859233 (View on PubMed)

Fan Y, Yuan L, Ji M, Yang J, Gao D. The effect of melatonin on early postoperative cognitive decline in elderly patients undergoing hip arthroplasty: A randomized controlled trial. J Clin Anesth. 2017 Jun;39:77-81. doi: 10.1016/j.jclinane.2017.03.023. Epub 2017 Mar 31.

Reference Type RESULT
PMID: 28494914 (View on PubMed)

Cardinali DP, Furio AM, Brusco LI. The use of chronobiotics in the resynchronization of the sleep/wake cycle. Therapeutical application in the early phases of Alzheimer's disease. Recent Pat Endocr Metab Immune Drug Discov. 2011 May;5(2):80-90. doi: 10.2174/187221411799015354.

Reference Type RESULT
PMID: 22074583 (View on PubMed)

Spinedi E, Cardinali DP. Neuroendocrine-Metabolic Dysfunction and Sleep Disturbances in Neurodegenerative Disorders: Focus on Alzheimer's Disease and Melatonin. Neuroendocrinology. 2019;108(4):354-364. doi: 10.1159/000494889. Epub 2018 Oct 28.

Reference Type RESULT
PMID: 30368508 (View on PubMed)

Marra A, McGrane TJ, Henson CP, Pandharipande PP. Melatonin in Critical Care. Crit Care Clin. 2019 Apr;35(2):329-340. doi: 10.1016/j.ccc.2018.11.008. Epub 2019 Jan 30.

Reference Type RESULT
PMID: 30784613 (View on PubMed)

Madsen BK, Zetner D, Moller AM, Rosenberg J. Melatonin for preoperative and postoperative anxiety in adults. Cochrane Database Syst Rev. 2020 Dec 8;12(12):CD009861. doi: 10.1002/14651858.CD009861.pub3.

Reference Type DERIVED
PMID: 33319916 (View on PubMed)

Other Identifiers

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melatonin POCD

Identifier Type: -

Identifier Source: org_study_id

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