Premedication with melatonin vs midazolam: efficacy on anxiety and compliance in paediatric surgical patients

Impellizzeri, Pietro; Vinci, E.; Gugliandolo, Maria Cristina; Cuzzocrea, Francesca; Larcan, Rosalba; Russo, Tiziana; Gravina, Maria Rosaria; Arena, Salvatore; D’Angelo, Gabriella; Gitto, Eloisa; Montalto, Angela Simona; Alibrandi, Angela; Romeo, Carmelo

doi:10.1007/s00431-017-2933-9

Cited by 39 publications

(51 citation statements)

References 40 publications

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“…was as effective as midazolam in reducing pre-operative anxiety. [ 54 , 55 ] With higher doses (0.75 mg/kg), melatonin was found to be more effective than midazolam for pre-operative anxiety without causing sedation and cognitive dysfunctions as midazolam did. [ 55 ] Patel et al (2015) found similar results with adults, whereas Caumo et al (2009) showed that melatonin was as effective as clonidine in reducing post-operative anxiety.…”

Section: Anxiety In Asdmentioning

confidence: 99%

Melatonin and Comorbidities in Children with Autism Spectrum Disorder

Gagnon

2018

Curr Dev Disord Rep

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Purpose of ReviewMelatonin is used to treat sleep difficulties associated with autism spectrum disorder (ASD). There are growing evidence that melatonin could have an effect on other symptoms than sleep, such as anxiety, depression, pain, and gastrointestinal dysfunctions. Interestingly, these symptoms frequently are found as comorbid conditions in individuals with ASD. We aimed to highlight the potential effect of melatonin on these symptoms.Recent FindingsAnimal and human studies show that melatonin reduces anxiety. Regarding the effect of melatonin on pain, animal studies are promising, but results remain heterogeneous in humans. Both animal and human studies have found that melatonin can have a positive effect on gastrointestinal dysfunction.SummaryMelatonin has the potential to act on a wide variety of symptoms associated with ASD. However, other than sleep difficulties, no studies exist on melatonin as a treatment for ASD comorbid conditions. Such investigations should be on the research agenda because melatonin could improve a multitude of ASD comorbidities and, consequently, improve well-being.

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Section: Anxiety In Asdmentioning

confidence: 99%

Melatonin and Comorbidities in Children with Autism Spectrum Disorder

Gagnon

2018

Curr Dev Disord Rep

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“…Several pharmacological treatments to mitigate the production of free radicals have been studied (i.e. therapy with maternal glucocortico-steroids and allopurinol, erythropoietin and melatonin, but an ideal therapeutic strategy has not yet been found [9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Ventilation, oxidative stress and risk of brain injury in preterm newborn

et al. 2020

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Preterm infants have an increased risk of cognitive and behavioral deficits and cerebral palsy compared to term born babies. Especially before 32 weeks of gestation, infants may require respiratory support, but at the same time, ventilation is known to induce oxidative stress, increasing the risk of brain injury. Ventilation may cause brain damage through two pathways: localized cerebral inflammatory response and hemodynamic instability. During ventilation, the most important causes of pro-inflammatory cytokine release are oxygen toxicity, barotrauma and volutrauma. The purpose of this review was to analyze the mechanism of ventilation-induced lung injury (VILI) and the relationship between brain injury and VILI in order to provide the safest possible respiratory support to a premature baby. As gentle ventilation from the delivery room is needed to reduce VILI, it is recommended to start ventilation with 21-30% oxygen, prefer a non-invasive respiratory approach and, if mechanical ventilation is required, prefer low Positive End-Expiratory Pressure and tidal volume.

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“…A dose range of melatonin premedication is used to provide sedation and analgesia without cognitive impairment and psychomotor skills, and without any increase in recovery time 512. Past studies have proven that melatonin is effective in the premedication of adults and children 131415. Anderson et al’s review7 which explored 24 clinical trials and 1749 participants suggested that melatonin decreases anxiety and pain, as compared to placebo.…”

Section: Introductionmentioning

confidence: 99%

Premedication effect of melatonin on propofol induction dose for anesthesia, anxiety, orientation and sedation after abdominal surgery: a double-blinded randomized trial

Norouzi¹,

Fateh²,

Modir³

et al. 2019

Med Gas Res

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The present study addressed the effect of melatonin premedication on propofol induction dose for anesthesia in abdominal surgery. This is a double-blinded clinical trial in which abdominal surgery patients admitted to the Valiasr Hospital, Iran ( n = 88) were enrolled and individually randomized into two groups: melatonin and placebo groups sublingually administered 3 mg of melatonin and placebo, respectively, 50 minutes before surgery. Their anxiety, orientation, and sedation were recorded before melatonin administration, anesthesia induction, and recovery, while we also recorded the propofol induction dose required for general anesthesia. Anxiety was seen less in the melatonin group than the placebo group ( P < 0.05), whereas orientation was significantly different before anesthesia induction ( P = 0.044) and sedation was the same before the induction ( P = 0.044) and recovery ( P = 0.049) in both groups, with a better efficiency in the melatonin group in which a lower dose of propofol was used ( P = 0.002). The sedation, anxiety, and propofol dose used were lower in the melatonin group than the placebo group. The recommended dosage was 3 mg of melatonin once to achieve an anesthetic depth index or a bispectral index of 40. The study was approved by Ethical Committee of Arak University of Medical Sciences with IR.ARAKMU.REC.1395.432 code in July 2016, and the trial was registered in Iranian Registry of Clinical Trials with IRCT20141209020258N98 in September 2016.

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Premedication with melatonin vs midazolam: efficacy on anxiety and compliance in paediatric surgical patients

Cited by 39 publications

References 40 publications

Melatonin and Comorbidities in Children with Autism Spectrum Disorder

Melatonin and Comorbidities in Children with Autism Spectrum Disorder

Ventilation, oxidative stress and risk of brain injury in preterm newborn

Premedication effect of melatonin on propofol induction dose for anesthesia, anxiety, orientation and sedation after abdominal surgery: a double-blinded randomized trial

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