A systematic review of peri‐operative melatonin

Andersen, Lars Peter Holst; Werner, Mads U.; Rosenberg, Jacob; Gögenur, Ismail

doi:10.1111/anae.12717

Cited by 88 publications

(106 citation statements)

References 64 publications

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“…Preoperative melatonin use as an anxiolytic agent with minimal side effects has been well-documented. (10,16,24) Similar to the results from Lee's thesis, (11) our study did not demonstrate a global effect; melatonin did not contribute significantly to reducing anxiety in all patients undergoing wisdom teeth extraction (p = 0.066). Contrary to previous publications, our study did not show preoperative anxiety to be significantly higher in female patients compared to male patients.…”

Section: Discussionsupporting

confidence: 89%

“…(21)(22)(23) However, Andersen et al also noted in a recent review article that other factors, including dosage used, administration route and timing of melatonin administration prior to surgery, may affect the effects of melatonin and that further studies were required to demonstrate the dose-response relationship for melatonin. (24) Despite a paucity of evidence for the overall benefit of melatonin in ameliorating postoperative pain in wisdom teeth extraction surgery, we have uncovered the interesting finding that after adjusting for gender, female patients who were given melatonin demonstrated faster pain reduction over time compared to those given a placebo (p = 0.020). The analgesic effect of melatonin in male patients was found to be absent.…”

Section: Discussionmentioning

confidence: 86%

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Melatonin premedication versus placebo in wisdom teeth extraction: a randomised controlled trial

Seet

Liaw

Tay

et al. 2015

smedj

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INTRODUCTIONPain after wisdom teeth surgery can be moderate in severity and is compounded by preoperative anxiety in young patients. We studied the effect of melatonin premedication on postoperative pain and preoperative anxiety in patients undergoing wisdom teeth extractions. METHODSThis randomised controlled trial recruited 76 patients at Khoo Teck Puat Hospital who were American Society of Anesthesiologists physical status I and II, aged 21 to 65 and scheduled to undergo elective extraction of all four wisdom teeth under general anaesthesia. Patients with a history of long-term use or allergy to melatonin were excluded. The patients received either 6 mg melatonin or a placebo 90 minutes before surgery. Visual analogue scale (VAS) scores at multiple time intervals for postoperative pain and preoperative anxiety, patient satisfaction and first-night sleep quality scores were obtained. Mixed-effects regression models were used for longitudinal analysis of VAS pain, anxiety and satisfaction scores.RESULTS Maximum VAS scores for pain and anxiety were 18.6 ± 19.1 mm at 60 minutes postoperatively and 26.2 ± 23.4 mm at 90 minutes preoperatively, respectively. After adjusting for gender, female patients who received melatonin had a faster rate of reduction of VAS pain (p = 0.020) and anxiety scores (p = 0.003) over time compared to the placebo group. No such effect was demonstrated in male patients. There was no significant difference in sleep quality or satisfaction scores.CONCLUSION Melatonin use did not consistently contribute to pain and anxiety amelioration in all patients. Our study demonstrated a positive effect in female patients, suggestive of sexual dimorphism.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 86%

Melatonin premedication versus placebo in wisdom teeth extraction: a randomised controlled trial

Seet

Liaw

Tay

et al. 2015

smedj

View full text Add to dashboard Cite

show abstract

“…Other external factors, such as fasting also reduced C max compared to fed state [25]. These findings may influence future dosing regimens in surgical patients receiving perioperative melatonin treatments [2,25]. In critically ill patients, an accelerated T max and extended T 1/2 were demonstrated, probably due to a reduced liver and kidney function in this patient category [3,16].…”

Section: Discussionmentioning

confidence: 74%

“…Correspondingly, exogenous melatonin has demonstrated a number of clinical effects [1,2]. Numerous clinical studies have documented improved sleep quality following administration of exogenous melatonin [1,3,4].…”

Section: Introductionmentioning

confidence: 99%

Clinical pharmacokinetics of melatonin: a systematic review

Harpsøe

Andersen

Gögenur

et al. 2015

Eur J Clin Pharmacol

245

164

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“…In human clinical studies, melatonin has been administered as an analgesic in the perioperative period, but the results have been inconsistent so far. 2 Interestingly, no human experimental studies investigating analgesic and antihyperalgesic properties of melatonin have been published yet.…”

Section: Introductionmentioning

confidence: 99%

Analgesic and antihyperalgesic effects of melatonin in a human inflammatory pain model

Andersen

Gögenur

Fenger

et al. 2015

Pain

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Antinociceptive effects of melatonin have been documented in a wide range of experimental animal models. The aim of this study was to investigate the analgesic, antihyperalgesic, and anti-inflammatory properties of melatonin using a validated burn injury (BI) model in healthy male volunteers. The design was a randomized, double-blind, placebo-controlled, three-arm crossover study. Each volunteer participated in 3 identical study sessions with intravenous administration of placebo, melatonin 10 mg, or melatonin 100 mg. Sixty minutes after bolus injection of study medication, a BI was induced by a computerized contact thermode (47.0°C, 420 seconds, 5.0 × 2.5 cm). Pain ratings during the BI and quantitative sensory testing at baseline and at 1, 2, 4, and 6 hours after the BI were performed. Quantitative sensory testing included assessments of secondary hyperalgesia areas, mechanical and thermal thresholds in the BI area, and pressure algometry. Furthermore, markers of inflammation, skin-reflectance spectrophotometry, and high-resolution ultrasonography were applied to measure skin erythema and dermal thickness in the BI area. Pain during the BI and secondary hyperalgesia areas were defined as primary outcomes. Twenty-nine volunteers were randomized and completed the study. While the BI induced large secondary hyperalgesia areas and significantly increased the markers of inflammation, no significant effects of melatonin were observed with respect to primary or secondary outcomes, compared with placebo. The administration of melatonin was not associated with any adverse effects. Melatonin did not demonstrate any analgesic, antihyperalgesic, or anti-inflammatory properties in the BI model.

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A systematic review of peri‐operative melatonin

Cited by 88 publications

References 64 publications

Melatonin premedication versus placebo in wisdom teeth extraction: a randomised controlled trial

Melatonin premedication versus placebo in wisdom teeth extraction: a randomised controlled trial

Clinical pharmacokinetics of melatonin: a systematic review

Analgesic and antihyperalgesic effects of melatonin in a human inflammatory pain model

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