Background: Preoperative anxiety is described as a state of uneasiness that mostpatients awaiting elective surgery experience and is a challenging concept in the preoperative care of the patients. Benzodiazepines are the most commonly used to reduce this anxiety.

Materials and methods: This prospective double blind study was designed to compare the effects of sublingual melatonin, alprazolam and melatonin alprazolam combination for premedication of adult patients during cataract surgery under topical anesthesia. 120 patients aged 40-80years scheduled for cataract surgery procedure were classified into three groups. Group 1 patients received melatonin 10mg, group 2 received alprazolam 0.5mg, group3 received melatonin 3mg and alprazolam 0.25mg combination, and all drugs were given sublingual 60min before the procedure. Sedation, anxiety and orientation score were quantified before premedication (T1) and 30min (T2), 60min (T3) and 90mins (T4).

Results: Mean ageof the study subjects was 61.3±7.92, 63.2±7.19 and 63.55±7.15 respectively. On applying t test, there was statistically significant difference between group 2 and group 3 at T3 and T4, also between group 1 and group 3 at T3.

Conclusion: Melatonin and melatonin alprazolam combination reduced anxiety scores,better sedation and provided excellent operating condition without hang over effect.