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Changes in Melatonin, Cortisol, and Body Temperature, and the Relationship Between Endogenous Melatonin Levels and Analgesia Consumption in Patients Undergoing Bariatric Surgery

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Abstract

Background

Melatonin has analgesic, anti-inflammatory, sedative, and anxiolytic properties. However, the relationship between endogenous melatonin levels and postoperative analgesic requirements has not been well elucidated in patients undergoing bariatric surgery. We studied endogenous melatonin levels, cortisol levels, body temperatures, and the relationship between the level of endogenous melatonin and postoperative morphine consumption.

Methods

The trial was conducted among 30 patients who were scheduled for laparoscopic bariatric surgery. Their ages were between 18 and 65 years and their BMIs were above 40 kg/m2. Secretion of melatonin, cortisol, and body temperature was monitored before the anesthetic induction, at 2 h intraoperatively, and at 2, 6, 10, (2:00 A.M.) and 24 h postoperatively. For each patient, morphine consumption was assessed at postoperative visits. The primary outcomes were to measure endogenous melatonin levels and to examine the relationship between these levels and morphine consumption. The secondary outcome was to observe the changes in cortisol and body temperature.

Results

There was a significant decrease in melatonin levels when preoperative melatonin levels were compared with intraoperative and all postoperative follow-up periods (p < 0.05). When the correlation between plasma melatonin levels and the postoperative morphine consumption of the patients was inspected, there was a significant correlation in all of the follow-up periods (p < 0.05). When preoperative cortisol levels were compared with intraoperative and postoperative cortisol levels, there was a significant difference in the follow-up periods, except two periods (p < 0.05). Body temperatures were similar in all measurement periods.

Conclusions

Endogenous melatonin secretion was significantly decreased in the intraoperative and postoperative periods. Furthermore, there was a significant inverse correlation between changes in endogenous melatonin levels and morphine consumption.

Trial Registration

Clinical Trial Number NCT03107702 from A service of the U.S. National Institutes of Health, clinicaltrials.gov

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Acknowledgements

We would like to thank Prof. Dr. Hakan Parlakpınar for his assistance with the study.

Funding

The financial support for the project number 2016/49 was supplied by the Inonu University Scientific Research Project Center.

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Authors and Affiliations

  1. Department of Anaesthesiology and Reanimation, Inonu University, School of Medicine, Malatya, Turkey

    Neslihan Altunkaya, Mehmet Ali Erdogan, Ulku Ozgul, Mukadder Sanli, Muharrem Ucar & Mahmut Durmus

  2. Department of Pharmacology, Inonu University, Faculty of Medicine, Malatya, Turkey

    Onural Ozhan

  3. Department of Surgery, Faculty of Medicine, Inonu University, Malatya, Turkey

    Fatih Sumer

  4. Department of Analytical Chemistry, Inonu University, Faculty of Pharmacy, Malatya, Turkey

    Selim Erdogan

  5. Department of Biostatistics, and Medical Informatics, Inonu University, School of Medicine, Malatya, Turkey

    Cemil Colak

Authors
  1. Neslihan Altunkaya
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  2. Mehmet Ali Erdogan
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  3. Ulku Ozgul
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  4. Mukadder Sanli
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  7. Fatih Sumer
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  8. Selim Erdogan
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  9. Cemil Colak
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  10. Mahmut Durmus
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Contributions

Neslihan Altunkaya conduct of the study, data collection. Attestation: Dr. Altunkaya approved. Mehmet Ali Erdogan study design, manuscript preparation. Attestation: Dr. Mehmet Ali Erdogan approved. Ulku Ozgul conduct of the study, data collection. Attestation: Dr. Ulku approved. Mukadder Sanli Data collection. Attestation: Dr. Sanli approved. Muharrem Ucar data collection, conduct of the study. Attestation: Dr. Ucar approved the final manuscript. Onural Ozhan analysis of samples. Attestation: Mr. Ozhan approved the final manuscript. Fatih Sumer data collection. Attestation: Dr. Sumer approved. Selim Erdogan analysis of samples. Attestation: Dr. Erdogan approved. Mahmut Durmuş manuscript preparation. Attestation: Dr. Durmus approved the final manuscript.

Corresponding author

Correspondence to Mehmet Ali Erdogan.

Ethics declarations

Informed Consent

Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

IRB: Malatya Clinical Research Ethics Committee, Inonu University, Malatya, Turkey inu.dhek@inonu.edu.tr

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Altunkaya, N., Erdogan, M.A., Ozgul, U. et al. Changes in Melatonin, Cortisol, and Body Temperature, and the Relationship Between Endogenous Melatonin Levels and Analgesia Consumption in Patients Undergoing Bariatric Surgery. OBES SURG 28, 3186–3192 (2018). https://doi.org/10.1007/s11695-018-3313-x

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  • DOI: https://doi.org/10.1007/s11695-018-3313-x

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