The relationship between anesthesia and melatonin: a review

Abstract

Introduction: This comprehensive review delves into the intricate and multifaceted relationship between anesthesia and melatonin, aiming to provide essential insights for perioperative clinical anesthesiologists and stimulate interest in related research. Anesthesia and surgery have the potential to disrupt melatonin secretion, leading to sleep disorders, postoperative neurocognitive dysfunction and other symptoms. In comparison to previous reviews, this review provides a comprehensive summary of the various aspects linking melatonin and anesthesia, going beyond isolated perspectives. It explores the potential benefits of administering melatonin during the perioperative period, including alleviating anxiety, reducing pain, enhancing perioperative sleep quality, as well as demonstrating immunomodulatory and anti-tumor effects, potentially offering significant advantages for cancer surgery patients.Recent Findings: Anesthesia and surgery have a significant impact on melatonin secretion, the hormone crucial for maintaining circadian rhythms. These procedures disrupt the normal secretion of melatonin, leading to various adverse effects such as sleep disturbances, pain, and postoperative neurocognitive dysfunction. However, the administration of exogenous melatonin during the perioperative period has yielded promising results. It has been observed that perioperative melatonin supplementation can effectively reduce anxiety levels, improve pain management, enhance the quality of perioperative sleep, and potentially decrease the occurrence of postoperative delirium. In recent years, studies have found that melatonin has the potential to improve immune function and exhibit anti-cancer effects, further underscoring its potential advantages for patients undergoing cancer surgery.Summary: In summary, melatonin can serve as an adjuvant drug for anesthesia during the perioperative period. Its administration has demonstrated numerous positive effects, including anti-anxiety properties, sedation, analgesia, improved postoperative sleep, and the potential to reduce the incidence of postoperative delirium. Furthermore, its immune-modulating and anti-tumor effects make it particularly valuable for cancer surgery patients. However, further studies are required to determine the optimal dosage, long-term safety, and potential adverse reactions associated with melatonin administration.

Dexmedetomidine for Preventing Sleep Disturbance after Ambulatory Anesthesia: A Case Report

“…1,2 Causes of these disturbances are multifactorial and may involve pain, postsurgical inflammation, personnel disturbances, and heightened awareness in unfamiliar environments. 1 Additionally, general anesthesia may contribute to postoperative sleep impairments, which likely result from circadian rhythm shifts as controlled by the body’s hypothalamic SCN, or “master clock.” 2,8,12 Through a gamma-aminobutyric acid (GABA)-mediated inhibitory effect, propofol has been shown to impair circadian rhythm generation and decrease endogenous melatonin secretion. 2,8,13 It has also been shown that the neural oscillatory (electroencephalogram) dynamics produced by medication-induced activation of GABAergic neurons differ from those produced by natural sleep.…”

“…1 Additionally, general anesthesia may contribute to postoperative sleep impairments, which likely result from circadian rhythm shifts as controlled by the body’s hypothalamic SCN, or “master clock.” 2,8,12 Through a gamma-aminobutyric acid (GABA)-mediated inhibitory effect, propofol has been shown to impair circadian rhythm generation and decrease endogenous melatonin secretion. 2,8,13 It has also been shown that the neural oscillatory (electroencephalogram) dynamics produced by medication-induced activation of GABAergic neurons differ from those produced by natural sleep. 14 Therefore, it has been emphasized that despite phenotypic similarities, sleep and anesthesia do not share identical biochemical mechanisms.…”

“…6,7 Propofol-induced sleep disturbance may be related to circadian rhythm alterations at the level of the suprachiasmatic nuclei (SCN) and impaired melatonin production. 8 Circadian rhythm sleep-wake disorders are known to be common among patients with autism spectrum disorder (ASD). 9 Furthermore, studies examining propofol administration among critically-ill patients have shown diminished or abolished rapid eye movement (REM) sleep, producing physiologic effects similar to insomnia.…”

Study on the preventive effect of dexmedetomidine on anesthetic associated sleep disturbance in young to middle-aged female patients undergoing hysteroscopy: a study protocol for a crossover randomized controlled trial

“…This results in a shift of the diurnal rhythm, with the onset of melatonin secretion occurring at an earlier or later point in the day. Furthermore, observational studies in humans have also shown delayed melatonin secretion and glucocorticoid release [ 23 ]. The potential disruption of the circadian timing system resulting from sleep irregularity during anesthesia may have a negative impact on human health and may hinder an individual’s ability to recover from surgery [ 24 ].…”