Preoperative anxiety is a prevalent issue among patients awaiting elective surgery often driven by

fear of the procedure, anesthesia or hospitalisation. This psychological state can trigger

sympathetic nervous system responses such as elevated heart rate, blood pressure, and perspiration,

which may complicate anesthesia management by increasing anaesthetic requirements and causing

hemodynamic instability. Traditionally, benzodiazepines like alprazolam have been widely used

for their anxiolytic and sedative properties. Alprazolam, a triazolebenzodiazepine, is considered

more anxioselective than others in its class; however, it is associated with drawbacks like cognitive

impairment, restlessness, and dependency risk. In contrast, melatonin a hormone naturally

secreted by the pineal gland has shown promise as a safer alternative. Melatonin induces sedation

and anxiolysis without impairing cognitive or psychomotor function and is known for its

antioxidant, anti-inflammatory, and chronobiotic effects. The current study aims to compare the

effectiveness of oral melatonin (6 mg) and oral alprazolam (0.5 mg) in reducing preoperative

anxiety and to assess their impact on sedation, orientation, cognitive function, and patient

satisfaction. This randomized, double-blind clinical trial will be conducted in the Department of

Anaesthesiology at RIMS, Imphal, enrolling 96 adult patients aged 18-60 years, categorised as

ASA grade I or I. Participants will be randomly assigned to one of two groups-melatonin or

alprazolam,-and administered their respective medications 120 minutes before anesthesia.

Preoperative anxiety, sedation, and cognitive functions will be assessed using validated tools like

the Visual Analogue Scale, Ramsay Sedation Score, Orientation Score, and Digit Symbol

Substitution Test. Standardised anesthesia will be provided across all groups. Data will be

statistically analyzed using SPSS, with significance set at p less than 0.05. This study seeks to address the

limited data comparing these two agents and aims to provide evidence based guidance on the use

of melatonin as a potential alternative to benzodiazepines in preoperative care.