This study assess the effect of administration of exogenous melatonin as adjuvant to propofol on the level of sedation and consequently the rate of propofol infusion.

38 patients with traumatic brain injuries requiring mechanical ventilation and sedation were randomly allocated to two groups (melatonin group)19 patients and (control group)19 patients. In both groups a bolus of propofol 1mglkg was given by titration till the patient reached a sedation level value of (60-70) on the bispectral index (BIS), Then propofol infusion started at a rate of 1mglkglhr as a maintenance and rate adjusted according to our targeted sedation level, melatonin 10 mg tablet was crushed and mixed with 20 ml of water and administrated through a nasogastric tube followed by another 20 ml to flush out the residue for (melatonin group). While (control Group) received a placebo tablets by the same wayBIS value and propofol infusion rate was recorded over 12 hours.

Inclusion Criteria:

• Age group from 18 to 65
• Both sexes
• Patients on a mechanical ventilation and need sedation
• Patients who are vitally stable

Exclusion Criteria:

• Gastro intestinal tract impractabililty
• Pregnant female
• Vitally unstable patients who cannot tolerate propofol infusion

De-identified participant data for primary and secondary outcome measures will be made available

one month

open

patient will be under general sedation