Comparison Of The Effects Of Melatonin Premedication And Ketamine On Postoperative Sleep Quality In Rhinoplasty

Purpose: Postoperative sleep disorders are common complications of surgery and anesthesia that increase morbidity and prolong hospital stay. Various methods are being explored to prevent and treat these issues. This study investigated the effects of melatonin and ketamine on postoperative sleep disturbances in patients undergoing rhinoplasty. Method: Based on a power analysis, 183 rhinoplasty patients were enrolled and randomized into three groups (n=61 each): Group M received 0.1 mg/kg oral melatonin pre- and postoperatively; Group K received 0.3 mg/kg IV ketamine intraoperatively; and Group MK received both regimens. Preoperative sleep quality was assessed using the RCSQ scale, and demographic data along with ASA scores were recorded. Intraoperative monitoring included baseline, post-intubation, and post-extubation vital parameters (HR, SAP, DAP, MAP), recorded at 30-minute intervals, as well as surgical and extubation times and remifentanil and sevoflurane consumption. Early complications during extubation (e.g., coughing, breath holding, desaturation, vomiting, laryngospasm) and later complications in the post-anesthesia care unit were documented. Patients\' sleep quality was re-evaluated on the first postoperative day using the RCSQ and NRS scales.