Effects of preoperative oral melatonin medication on postoperative analgesia, sleep quality, and sedation in patients undergoing elective prostatectomy: a randomized clinical trial

Borazan, Hale; Tuncer, Sema; Yalçın, Naime; Erol, Atilla; Otelcioğlu, Şeref

doi:10.1007/s00540-010-0891-8

Cited by 75 publications

(107 citation statements)

References 24 publications

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“…(27) Previous studies have shown slight improvements in sleep quality in the early postoperative period when patients were given melatonin compared to a placebo. (18,20,28) However, our study did not demonstrate a significant difference in sleep quality between both groups (p = 0.830).…”

Section: Discussioncontrasting

confidence: 78%

“…(17)(18)(19) A study by Borazan et al in patients undergoing elective prostatectomy also showed a significant decrease in postoperative pain when a dual-dosing regimen was used. (20) In contrast, studies which used a once-only dosing for melatonin did not show a significant difference in pain scores when compared with a placebo. (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.…”

Section: Discussionmentioning

confidence: 94%

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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: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 94%

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

Seet

Liaw

Tay

et al. 2015

smedj

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“…Most studies gave melatonin 30-100 min before surgery [4, 12, 14, 17-24, 27, 29-31]. One study gave melatonin daily for one month pre-operatively [28], whereas four studies gave melatonin the night before surgery, in addition to the immediate pre-operative dose [5,6,13,15]. Three studies gave melatonin at surgical incision [25,26] or after intubation [32].…”

Section: Resultsmentioning

confidence: 99%

“…Participants had various operations: abdominal [15][16][17]25, Full-text studies excluded (n = 17) -10 studies did not investigate surgical patients -3 studies were protocol studies -2 studies were not randomised -2 studies used melatonin only in combination with other drug interventions 32]; dental [27]; gynaecological [5,6,18,19,30]; ophthalmological [4,14]; orthopaedic [12]; thoracic [28,29]; urological [13]; vascular [26]; and mixed [20][21][22][23][24]31]. The anaesthetic techniques included: general anaesthesia [13,[15][16][17][18][19][20][21][22][23][24][25][26][28][29][30][31][32]; intravenous regional anaesthesia [12]; neuraxial block [5,6,20,26,31]; sedation …”

Section: Resultsmentioning

confidence: 99%

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A systematic review of peri‐operative melatonin

Andersen

Werner²,

Rosenberg

et al. 2014

Anaesthesia

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SummaryWe systematically reviewed randomised controlled trials of peri-operative melatonin. We included 24 studies of 1794 participants that reported eight peri-operative outcomes: anxiety; analgesia; sleep quality; oxidative stress; emergence behaviour; anaesthetic requirements; steal induction; and safety. Compared with placebo, melatonin reduced the standardised mean difference (95% CI) pre-operative anxiety score by 0.88 (0.44-1.33) and postoperative pain score by 1.06 (0.23-1.88). The magnitude of effect was unreliable due to substantial statistical heterogeneity, with I 2 87% and 94%, respectively. Qualitative reviews suggested the melatonin improved sleep quality and emergence behaviour, and might be capable of reducing oxidative stress and anaesthetic requirements.

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Melatonin for pre- and postoperative anxiety in adults

Hansen

Halladin

Rosenberg

et al. 2015

Cochrane Database of Systematic Reviews

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BackgroundAnxiety in relation to surgery is a well-known problem. Melatonin offers an atoxic alternative to benzodiazepines in ameliorating this condition in the pre-and postoperative period. ObjectivesTo assess the effect of melatonin on pre-and postoperative anxiety in adults when comparing melatonin with placebo or when comparing melatonin with benzodiazepines. Search methodsThe following databases were searched on 19 April 2013: CENTRAL, MEDLINE, EMBASE, CINAHL and Web of Science. For ongoing trials and protocols we searched clinicaltrials.gov, Current Controlled Trials and the World Health Organization (WHO) International Clinical Trials Registry Platform. We reran the search in October 2014. We will deal with any studies of interest when we update the review. Selection criteriaRandomized, placebo-controlled or standard treatment-controlled, or both, studies that evaluated the effect of preoperatively administered melatonin on preoperative or postoperative anxiety. We included adult patients of both genders (15 to 90 years of age) undergoing any kind of surgical procedure in which it was necessary to use general, regional or topical anaesthesia. Data collection and analysisData were extracted independently by two review authors. Data extracted included information about study design, country of origin, number of participants and demographic details, type of surgery, type of anaesthesia, intervention and dosing regimen, preoperative anxiety outcome measures and postoperative anxiety outcome measures.

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Effects of preoperative oral melatonin medication on postoperative analgesia, sleep quality, and sedation in patients undergoing elective prostatectomy: a randomized clinical trial

Abstract: Preoperative oral melatonin administration decreased pain scores and tramadol consumption and enhanced sleep quality, sedation scores, and subjective analgesic efficacy during the postoperative period.

Cited by 75 publications

References 24 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

A systematic review of peri‐operative melatonin

Melatonin for pre- and postoperative anxiety in adults

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