The Effect of Melatonin on Anxiety and Pain of Tourniquet in Intravenous Regional Anesthesia

Abbasivash, Rahman; Salimi, Sohrab; Ahsan, B; Moallemi, Neda; Sane, Shahryar

doi:10.4103/abr.abr_106_19

Cited by 16 publications

(11 citation statements)

References 15 publications

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“…In heterogeneous clinical conditions, several recent trials have shown the potential of exogenous melatonin in the management of anxiety-related symptoms in somatic conditions with disturbances in sleep and circadian rhythms. In patients undergoing intravenous regional anesthesia, melatonin is associated with reduced anxiety, decreased tourniquet-related pain, and improved perioperative analgesia [69]. A Cochrane review concluded that melatonin reduced pre-operative and post-operative anxiety with an effect equal to benzodiazepines [70].…”

Section: Anxiety and Anxiety Disordersmentioning

confidence: 99%

Role of Melatonin in the Management of Sleep and Circadian Disorders in the Context of Psychiatric Illness

Moon

Kim

Partonen

et al. 2022

Curr Psychiatry Rep

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Purpose of Review We present a review of research on the role of melatonin in the management of sleep and circadian disorders, stressing current overall view of the knowledge across psychiatric disorders. Recent Findings Dysregulation of sleep and circadian rhythms has been established in several psychiatric and neurocognitive disorders for long. Recent research confirms this finding consistently across disorders. The secretion of melatonin in schizophrenia and neurocognitive disorders is reduced due to a smaller volume and enlarged calcification of the pineal gland. On the other hand, melatonin dysregulation in bipolar disorder may be more dynamic and caused by light-sensitive melatonin suppression and delayed melatonin secretion. In both cases, exogenous melatonin seems indicated to correct the dysfunction. However, a very limited number of well-designed trials with melatonin to correct sleep and circadian rhythms exist in psychiatric disorders, and the evidence for efficacy is robust only in autism, attention deficit hyperactivity disorder (ADHD), and neurocognitive disorders. This topic has mainly not been of interest for recent work and well-designed trials with objective circadian parameters are few. Overall, recent studies in psychiatric disorders reported that melatonin can be effective in improving sleep parameters such as sleep onset latency, sleep efficiency, and sleep quality. Recent meta-analysis suggests that optimal dosage and dosing time might be important to maximize the efficacy of melatonin. The knowledge base is sufficient to propose well-designed, larger trials with circadian parameters as inclusion and outcome criteria. Based on the partly fragmentary information, we propose testing efficacy in disorders with neurocognitive etiopathology with later and higher dosing, and affective and anxiety disorders with lower and earlier dosing of melatonin. Summary Melatonin is promising for the correction of sleep and circadian abnormalities in psychiatric disorders. However, research results on its effect are still few and need to be accumulated. For effective use of melatonin, it is necessary to consider the appropriate dosage and administration time, depending on the individual abnormality of sleep and circadian rhythms.

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Section: Anxiety and Anxiety Disordersmentioning

confidence: 99%

Role of Melatonin in the Management of Sleep and Circadian Disorders in the Context of Psychiatric Illness

Moon

Kim

Partonen

et al. 2022

Curr Psychiatry Rep

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“…Concerning vaccines, exogenous melatonin acts as an adjuvant enhancing the response of CD8 + T cells in cancer vaccines (30,31) and vaccines employed against several pathogens in veterinary medicine (32). Melatonin increases the immune response to vaccines by increasing both CD4 + T cells and B cells that express IgG in peripheral blood.…”

Section: Melatonin As An Immunoenhancement Adjuvant In Anti-sars-cov-mentioning

confidence: 99%

An urgent proposal for the immediate use of melatonin as an adjuvant to anti- SARS-CoV-2 vaccination

2021

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Competition among pharmaceutical companies to develop safe and effective vaccines against SARS-CoV-2 is high. However, based on the prior experience with the influenza vaccine, up to 50% in lack of effectiveness would be found among healthy adults receiving effective vaccines against SARS-CoV-2. There is growing evidence that insufficient sleep may potentially be a pervasive and prominent factor accounting for this variability. Individuals experiencing total or partial sleep loss exhibit markedly reduced antigen-specific antibodies as compared to healthy sleepers. Besides, pre-vaccination sleep quality is also an important contributing factor. Several meta-analyses and expert consensus reports support the view that the chronobiotic/hypnotic properties of melatonin are useful in patients with primary sleep disorders to decrease sleep onset latency and to increase total sleep time. Hence, the prescription of melatonin for at least 2 weeks prior to vaccination can be a useful approach to improve sleep quality and to ensure that the vaccination is performed at a moment of optimal sleep conditions. Moreover, melatonin enhances the immune response to vaccines by increasing peripheral blood CD4+ T cells and IgG-expressing B cells. Administration of exogenous melatonin could increase the potency of the immune response and the duration of the immunity induced by the vaccine. Besides, melatonin could also prevent adverse effects of the vaccination due to its antioxidant and immunomodulatory properties. Therefore, the administration of melatonin from 2 weeks to at least 4 weeks after vaccination may constitute an effective means to enhance the efficacy of vaccination against SARS-CoV-2.

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“…For example, Shah et al (2016) compared anxiety relief under spinal anaesthesia in groups of people who were administered Propofol and Dexmedetomidine, respectively. Moreover, Abbasivash et al (2019) attempted to use Melatonin to mediate intraoperative anxiety in patients under spinal anaesthesia to avoid overuse of Propofol. However, despite their benefits, Dexmedetomidine and Melatonin used in both studies have a longer half‐life than Propofol and are related to slower recovery from anaesthesia (Abbasivash et al, 2019; Shah et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, Abbasivash et al (2019) attempted to use Melatonin to mediate intraoperative anxiety in patients under spinal anaesthesia to avoid overuse of Propofol. However, despite their benefits, Dexmedetomidine and Melatonin used in both studies have a longer half‐life than Propofol and are related to slower recovery from anaesthesia (Abbasivash et al, 2019; Shah et al, 2016). Thus, non‐pharmacological interventions should be considered to relieve intraoperative anxiety.…”

Section: Introductionmentioning

confidence: 99%

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Integrative review of non‐pharmacological intervention and multidimensional evaluation for intraoperative anxiety under spinal anaesthesia

Lim

Jung

Kim

2022

Journal of Clinical Nursing

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Introduction Patients under spinal anaesthesia experience high levels of anxiety during surgery. Clinical nurses tried to manage patient's anxiety under spinal anaesthesia using non‐pharmacological interventions for its benefit. Thus, it is required to identify comprehensive evidences of various non‐pharmacological interventions and of how to measure anxiety under spinal anaesthesia. Aims This study aims to review current research on the non‐pharmacological interventions to relieve intraoperative anxiety under spinal anaesthesia and to identify subjective and objective measures of intraoperative anxiety under spinal anaesthesia. Methods Wittemore and Knafl's integrative review methodology was used. Researchers conducted five scientific rigor steps; problem identification, searching literature, evaluation of literature, analysis of literature and presentation of results. The PRISMA checklist was used. To evaluate the level of evidence, critical appraisal tools of Joanna Briggs Institute were used. Results Eleven studies were included in this integrative review. Delivering music is the most frequently used as non‐pharmacological intervention by researchers. They tried to manage intraoperative anxiety under spinal anaesthesia with using diverse genre and application of music. In addition, dry cupping method, progressive muscle relaxation (PMR) exercise and virtual reality (VR) goggles were used in included studies. Researchers measured intraoperative anxiety under spinal anaesthesia with objective or subjective way. The State‐Trait Anxiety Inventory and visual analogue scale were used as subjective method to approach intraoperative anxiety. In contrary, researchers tried to obtain objective evidence of intraoperative anxiety with vital signs, cortisol, blood glucose, alpha‐amylase and adrenocorticotropic hormone. Conclusion Various types of non‐pharmacological interventions are effective to manage patient's intraoperative anxiety under spinal anaesthesia. It is recommended to measure intraoperative anxiety under spinal anaesthesia with using both objective and subjective methods. Relevance to Clinical Practice Clinical nurses can use non‐pharmacological interventions to manage intraoperative anxiety under spinal anaesthesia by comprehensive monitoring with diverse measures.

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The Effect of Melatonin on Anxiety and Pain of Tourniquet in Intravenous Regional Anesthesia

Cited by 16 publications

References 15 publications

Role of Melatonin in the Management of Sleep and Circadian Disorders in the Context of Psychiatric Illness

Role of Melatonin in the Management of Sleep and Circadian Disorders in the Context of Psychiatric Illness

An urgent proposal for the immediate use of melatonin as an adjuvant to anti- SARS-CoV-2 vaccination

Integrative review of non‐pharmacological intervention and multidimensional evaluation for intraoperative anxiety under spinal anaesthesia

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