الفهرس 
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Abstract
This prospective, randomized, double blinded, and placebo controlled study was conducted in El-Minia University Hospital during the period from December 2018 to May 2019. A total of 90 women , aged between 21 and 40 years with American Society of Anesthesiologists grade I and II patients scheduled to undergo elective gynecological laparoscopic surgery under general anesthesia with endotracheal intubation , were included in the study.
This study was conducted to evaluate the effect of oral melatonin versus oral pregabalin in attenuating the hemodynamic responses to endotracheal intubation, in addition, comparing their effect on preoperative anxiety.
Patients were randomly divided into three equal groups.Two hours before operation, the control group (C) received vit D orally as a placebo, group (M) received 6mg of melatonin orally and group (P) received 150mg of pregabalin orally. Anesthetic technique was standardized in all the 3 groups.
The following variables (SBP, DBP, MAP,HR, SpO2) were recorded just before medications (baseline),2 hours after medications(just before induction of anesthesia), after induction (just before intubation), 1 min, 3 min, 5 min, and10 min after intubation. Also, RASS score was recorded just before medications (baseline) and 2 hours after medications ( just before induction of anesthesia).
In addition, serum norepinephrine level was measured just before medications (baseline), 2 hours after medications (just before induction of anesthesia), 1 min, and 5 min after intubation. Adverse effects such as tachycardia, bradycardia, arrhythmias, hypertension, hypotension, respiratory depression, headache, nausea, vomiting, restlessness, or stridor were reported and compared among the three groups.
In this study changes in SBP, DBP, MAP, HR, RASS score and serum norepinephrine level values were noted to be similar to each other during the study period. Thus, there were significant rises in the values before induction and 2 hours after administration of medications in due to preoperative anxiety and after endotracheal intubation because of the pressor response to endotracheal intubation. There were significant differences in value between the 3 groups with the lowest values were in melatonin group and the highest were in control group while pregabalin group values were in the middle between the 2 other groups.
There was no significant difference between the 3 study groups regarding the incidence of adverse effects during the study period.