Melatonin for preoperative and postoperative anxiety in adults

Madsen, Bjarne; Zetner, Dennis; Møller, Ann Merete; Rosenberg, Jacob

doi:10.1002/14651858.cd009861.pub3

Cited by 48 publications

(52 citation statements)

References 123 publications

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“…Doses between 1 mg and 6 mg appear to be effective for improving sleep in older adults [29]. In clinical trials investigating anxiety, melatonin in doses varied from 3 to 10 mg probably reduced preoperative anxiety in adults, which is potentially clinically relevant [30]. Available studies show, that short-time use of melatonin, even in very high doses, is safe.…”

Section: Introductionmentioning

confidence: 99%

Cumulative Protective Effect of Melatonin and Indole-3-Propionic Acid against KIO3—Induced Lipid Peroxidation in Porcine Thyroid

Iwan

Stępniak

Karbownik-Lewińska

2021

Toxics

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Iodine deficiency is the main environmental factor leading to thyroid cancer. At the same time iodine excess may also contribute to thyroid cancer. Potassium iodate (KIO3), which is broadly used in salt iodization program, may increase oxidative damage to membrane lipids (lipid peroxidation, LPO) under experimental conditions, with the strongest damaging effect at KIO3 concentration of ~10 mM (corresponding to physiological iodine concentration in the thyroid). Melatonin and indole-3-propionic acid (IPA) are effective antioxidative indoles, each of which protects against KIO3-induced LPO in the thyroid. The study aims to check if melatonin used together with IPA (in their highest achievable in vitro concentrations) reveals stronger protective effects against KIO3-induced LPO in porcine thyroid homogenates than each of these antioxidants used separately. Homogenates were incubated in the presence of KIO3 (200; 100; 50; 25; 20; 15; 10; 7.5; 5.0; 2.5; 1.25; 0.0 mM) without/with melatonin (5 mM) or without/with IPA (10 mM) or without/with melatonin + IPA, and then, to further clarify the narrow range of KIO3 concentrations, against which melatonin + IPA reveal cumulative protective effects, the following KIO3 concentrations were used: 20; 18.75; 17.5; 16.25; 15; 13.75; 12.5; 11.25; 10; 8.75; 7.5; 0.0 mM. Malondialdehyde + 4-hydroxyalkenals (MDA + 4-HDA) concentration (LPO index) was measured spectrophotometrically. Protective effects of melatonin + IPA were stronger than those revealed by each antioxidant used separately, but only when LPO was induced by KIO3 in concentrations from 18.75 mM to 8.75 mM, corresponding to physiological iodine concentration in the thyroid. In conclusion, melatonin and indole-3-propionic acid exert cumulative protective effects against oxidative damage caused by KIO3, when this prooxidant is used in concentrations close to physiological iodine concentrations in the thyroid. Therefore, the simultaneous administration of these two indoles should be considered to prevent more effectively oxidative damage (and thereby thyroid cancer formation) caused by iodine compounds applied in iodine prophylaxis.

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Section: Introductionmentioning

confidence: 99%

Cumulative Protective Effect of Melatonin and Indole-3-Propionic Acid against KIO3—Induced Lipid Peroxidation in Porcine Thyroid

Iwan

Stępniak

Karbownik-Lewińska

2021

Toxics

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“…According to a systematic review of 27 randomized controlled trials (involving 2319 participants), melatonin (doses varied from 3 to 10 mg per day) is more effective than a placebo in reducing anxiety. Moreover, it has a similar effect to benzodiazepines (midazolam and alprazolam), but melatonin is better tolerated [ 85 ]. Also, this compound significantly reduces the risk of depressive symptoms and anxiety in women with breast cancer [ 86 ], and in the same population melatonin improved sleep efficiency [ 87 ].…”

Section: Anxiety Insomnia and Melatoninmentioning

confidence: 99%

Potential and Possible Therapeutic Effects of Melatonin on SARS-CoV-2 Infection

et al. 2022

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The absence of effective drugs for COVID-19 prevention and treatment requires the search for new candidates among approved medicines. Fundamental studies and clinical observations allow us to approach an understanding of the mechanisms of damage and protection from exposure to SARS-CoV-2, to identify possible points of application for pharmacological interventions. In this review we presented studies on the anti-inflammatory, antioxidant, and immunotropic properties of melatonin. We have attempted to present scientifically proven mechanisms of action for the potential therapeutic use of melatonin during SARS-CoV-2 infection. A wide range of pharmacological properties allows its inclusion as an effective addition to the methods of prevention and treatment of COVID-19.

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“…Furthermore, melatonin is non‐toxic and only mild adverse effects such as dizziness, headaches and nausea have been reported 12 . A recent Cochrane review on the subject found that melatonin may be useful in decreasing preoperative anxiety 13 . The optimal dosage however is still unclear and the previous studies used everything from 3 to 10 mg of melatonin 13 .…”

Section: Introductionmentioning

confidence: 99%

“…A recent Cochrane review on the subject found that melatonin may be useful in decreasing preoperative anxiety 13 . The optimal dosage however is still unclear and the previous studies used everything from 3 to 10 mg of melatonin 13 . Additionally, surgery and general anaesthesia are associated with subsequent decreased sleep quality 14 .…”

Section: Introductionmentioning

confidence: 99%

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Oral melatonin did not reduce anxiety before elective hernia repair: A randomised, double‐blinded, placebo‐controlled trial

Holm

Gram-Hanssen

Madsen

et al. 2022

Acta Anaesthesiol Scand

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Background: Preoperative anxiety is a common issue in surgery. Preoperative anxiety may lead to increased mortality, pain and dissatisfaction with surgery. Melatonin is a drug with only mild adverse effects and has previously been shown to reduce anxiety and pain in the perioperative setting. The aim of study was to investigate the anxiolytic effect of melatonin in the preoperative setting.Methods: This study was a randomised, double-blinded, placebo-controlled clinical trial. Included patients were allocated in the ratio 1:1 to either the placebo group or the melatonin group. Patients received 10 mg melatonin or placebo the evening before surgery, 2 h before surgery, immediately after surgery and the evening after surgery. Preoperative anxiety was examined 1 h before surgery, using the State Trait Anxiety Inventory (STAI) questionnaire, along with a Visual Analogue Scale (VAS) of anxiety. Furthermore, participants filled out a sleep log each morning, where we examined sleep quality, comfort and drowsiness.Results: Sixteen patients received placebo treatment and 17 patients received melatonin. Median state anxiety on the STAI scale at baseline was 27 (interquartile range[IQR] 22-34) for the melatonin group and 27 for the placebo group. In the primary outcome of preoperative anxiety 1 h before surgery, the median state anxiety on the STAI scale was 27 (IQR 24-34) for the melatonin group and 28 (24-33) for the placebo group, p = .814. VAS anxiety was median 7 (0-28) for the melatonin group and median 7 (1-13) for the placebo group, p = .813. Furthermore, there were no statistically significant differences between the two groups in the secondary outcomes of sleep quality and consumption of analgesics. Conclusion:Melatonin did not reduce preoperative anxiety in patients undergoing hernia repair. Preoperative anxiety levels were low, which limits the generalisability of our findings.

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Melatonin for preoperative and postoperative anxiety in adults

Cited by 48 publications

References 123 publications

Cumulative Protective Effect of Melatonin and Indole-3-Propionic Acid against KIO3—Induced Lipid Peroxidation in Porcine Thyroid

Cumulative Protective Effect of Melatonin and Indole-3-Propionic Acid against KIO3—Induced Lipid Peroxidation in Porcine Thyroid

Potential and Possible Therapeutic Effects of Melatonin on SARS-CoV-2 Infection

Oral melatonin did not reduce anxiety before elective hernia repair: A randomised, double‐blinded, placebo‐controlled trial

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