This study evaluated the efficacy of transdermal fentanyl (TDF) delivery system (50 lg/h) or transdermal melatonin (TDM) delivery system (7 mg) 2 h preoperatively for acute postoperative pain after lumbar laminectomy compared to placebo group (C). Methods: Seventy-five patients of both sexes, aged 18-50 years, ASA I and II undergoing elective single level lumber laminectomy under general anesthesia were included in this randomized controlled double-blind study. Patients were randomly divided

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... o 3 groups 25 each, C group patients received transdermal placebo patch, TDF group (50 lg/h) and TDM group (7 mg). Assessment of postoperative pain, sedation, hemodynamic variables such as HR and MAP, postoperative monitoring of arterial SpO 2 and side effects (e.g. nausea, vomiting, pruritis, respiratory depression and hemodynamic instability) was done 30 min, 1, 2, 6 and 12 h postoperatively. Postoperative Patient's and Surgeons' satisfaction, Intraoperative bleeding and plasma cortisol (lg/dl) postoperatively were also assessed. Results: There was a significant reduction in the VAS score, total pethidine requirements and significantly higher Patient's satisfaction in TDF and TDM groups when compared with the C group 6 h postoperatively. The sedation score and Surgeons' satisfaction were significantly higher associated with a significant decrease in MAP and Intraoperative bleeding in TDM group compared to groups C and TDF 6 h postoperatively. Significant nausea and vomiting in TDF group and significant sedation in TDM group were recorded.