Efficacy and Safety of Melatonin as an Anxiolytic and Analgesic in the Perioperative Period

Abstract

Melatonin possesses sedative, hypnotic, analgesic, antiinflammatory, antioxidative, and chronobiotic properties that distinguish it as an attractive alternative premedicant. A qualitative systematic review of the literature concerning the perioperative use of melatonin as an anxiolytic or analgesic in adult patients was carried out using the recommended guidelines provided by the Cochrane Handbook for Systematic Reviews of Interventions. Nine of the 10 studies showed statistically significant reduction of preoperative anxiety with melatonin premedication compared with placebo. An opioid-sparing effect or reduced pain scores were evident in five studies whereas three studies were contradictory. Thus, melatonin premedication is effective in ameliorating preoperative anxiety in adults, but its analgesic effects remain controversial in the perioperative period. Additional well designed randomized controlled trials are necessary to compare melatonin premedication with other pharmacological interventions, investigate its effect on more varied surgical populations, and to delineate its optimal dosing regimen.

Comparison of Effects of Melatonin and Gabapentin on Post Operative Anxiety and Pain in Lumbar Spine Surgery: A Randomized Clinical Trial

“…Previous studies have shown the effectiveness of both drugs in reducing pain and anxiety after a variety of surgeries (13-15, 17-21). A systematic review study in Canada found that in 9 out of 10 randomized clinical trials in adults over the period 2008-2010, melatonin was effective in reducing preoperative anxiety compared with placebo (16). In one study by Khezri et al, anxiolytic and pain relief effects of gabapentin and melatonin in cataract surgery were compared.…”

“…A total of 100 minutes before induction of anesthesia in melatonin (ESI, Italy), gabapentin (Daro Pakhsh, Iran), and placebo groups a total of 6 mg melatonin, and 600 mg gabapentin orally, and dummy pill as a placebo (that manufactured by pharmacology school) with 30 ml of distilled water, were respectively prescribed. Melatonin and gabapentin doses were selected based on previous studies (16). After transferring the patient to the operating room bed, all patients undergo standard monitoring including electrocardiogram, pulse oximetry, and non-invasive measurements of blood pressure and heart rate.…”

The effect of acute exogenous melatonin on P50 suppression in healthy male volunteers stratified for low and high gating levels

“…However, this is unlikely since diazepam (a benzodiazepine) neither seems to reduce P50 amplitudes nor to affect P50 gating (Van Luijtelaar, 2003). There is some evidence that stress reduces P50 suppression (Yee and White, 2001), while melatonin is known to reduce levels of stress (Yousaf et al, 2010). Therefore, a fourth alternative would be that the levels of stress between high and low suppressors had influenced our results.…”

A double-blind, placebo-controlled intervention trial of 3 and 10 mg sublingual melatonin for post-concussion syndrome in youths (PLAYGAME): study protocol for a randomized controlled trial

“…It is also effective in treating anxiety. In a systematic review, premedication with melatonin significantly decreased preoperative anxiety [113]. …”