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Melatonin for anaesthetic indications in paediatric patients: a systematic review

D Procaccini1, K Lobner1, R Azamfirei1

  • 1Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Anaesthesia
|September 16, 2020
PubMed

Insights

Melatonin is safe for pediatric anesthesia indications, potentially easing pain and reducing the need for general anesthesia in children. This systematic review categorizes its uses for sedation and as an anesthetic adjunct.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Systematic Review

Background:

  • Melatonin's favorable safety profile and widespread availability have increased its clinical use in both adults and children.
  • Its application in pediatric anesthesia settings warrants a comprehensive review of existing evidence.

Purpose of the Study:

  • To systematically review published studies on the use of melatonin for anesthetic indications in pediatric patients.
  • To categorize melatonin's applications within pediatric anesthesia, including analgesia, sedation, and adjunct use.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed, EMBASE, CINAHL, Web of Science, Scopus).
  • Two independent reviewers screened titles, abstracts, and full texts of identified articles.
  • Twenty-seven eligible studies investigating melatonin for pediatric anesthetic indications were included.

Main Results:

  • Significant heterogeneity in study methodologies precluded quantitative synthesis.
  • Studies were categorized by indication: analgesia, diagnostic sedation, and anesthetic adjunct.
  • Melatonin demonstrated safety across these indications.

Conclusions:

  • Melatonin is safe for pediatric anesthetic-related indications.
  • It may provide analgesia for inflammatory pain (e.g., before venipuncture) in neonates and children.
  • It may reduce or replace general anesthesia for diagnostic procedures and serve as an adjunct before induction.

Keywords:
anaesthesia adjunctanalgesiadiagnostic sedationmelatoninpaediatricspre-operative anxiety

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