en چشم Ophthalmology پژوهشي Research <div style="text-align: justify;"><span style="font-family:Tahoma;"><span style="font-size:12px;"><span style="line-height:2;"><b><span lang="EN-GB">Introduction:</span></b> Maintaining hemodynamic stability during cataract surgery is crucial, particularly in elderly patients or those with underlying medical conditions. Melatonin and midazolam are among the medications used for sedation and improving intraoperative conditions; however, they may have different effects on hemodynamic parameters. This study aimed to compare the impact of these two medications on hemodynamic status before, during, and after cataract surgery.<br> <b><span lang="EN-GB">Methods:</span></b> This clinical trial was conducted on 40 patients scheduled for cataract surgery under general anesthesia. Participants were randomly assigned to one of two intervention groups; one of which received 0.1 mg/kg of oral melatonin, while the other received 70&ndash;80 &micro;g/kg of intravenous midazolam. Both administrations occurred 1 h before surgery. A Saadat monitor was used to record hemodynamic parameters, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR), at three intervals: 30 min before the operation, during the operation, and 6 h after the operation. Statistical analysis was performed in SPSS software (version 26), employing a significance threshold of <i>p</i> < 0.05.<br> <b><span lang="EN-GB">Results:</span></b> Analysis indicated that hemodynamic parameters, including SBP, DBP, and HR, were comparable between the two groups before, during, and after the operation, with no statistically significant intergroup differences (<i>p</i> > 0.05). In contrast, a significant intragroup change was observed in the melatonin group regarding HR over time (<i>p</i> = 0.005).<br> <b><span lang="EN-GB">Conclusion:</span></b> Although both medications were effective in maintaining hemodynamic stability, melatonin resulted in better stability of HR after surgery, compared to midazolam. Therefore, given its fewer side effects and efficacy on regulating HR, melatonin could be considered a safer alternative for patients prone to tachycardia in cataract surgery.</span></span></span><br> <br> <span style="font-size:11pt"><span><span><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Zar""></span></span></span></span></span></span></span></span></span></span></div> Cataract, General Anesthesia, Melatonin, Midazolam, Surgery 96 102 http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-486-1&slc_lang=en&sid=1 Maliheh Zangoue mzangoue@yahoo.com 100319475328460011602 100319475328460011602 No Department of Anesthesiology, School of Medicine. Birjand University of Medical Sciences, Birjand, Iran Simin Sharafi Siminsharafi68@gmail.com 100319475328460011603 100319475328460011603 No Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran Atefe Shaarbaf Yazdi majid121.jamali@gmail.com 100319475328460011604 0009-0009-9041-8673 No General physicion, Birjand University of Medical Sciences, Birjand, Iran Maryam Tolyat tolyatm@yahoo.com 100319475328460011605 100319475328460011605 Yes School of Allied Medical Sciences. Birjand University of Medical Sciences, Birjand, Iran