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Melatonin for non-operating room sedation in paediatric population: a systematic review and meta-analysis

Javed Ahmed1, Waseemoddin Patel2, Abdul Kareem Pullattayil3

  • 1Neonatology, Hamad Medical Corporation, Doha, Qatar.

Archives of Disease in Childhood
|March 31, 2021
PubMed

Insights

Limited studies show melatonin is not definitively effective for pediatric non-operating room sedation. While generally safe, high-quality evidence is lacking to confirm its efficacy for procedures like EEG, MRI, and BAER.

Area of Science:

  • Pediatric Sedation
  • Pharmacology
  • Systematic Review

Background:

  • Literature on melatonin's use as a sedative in children is scarce.
  • Non-operating room (NOR) procedures in children often require sedation for patient comfort and data acquisition.

Purpose of the Study:

  • To systematically review the efficacy and safety of melatonin for NOR sedation in pediatric patients.
  • To synthesize evidence from clinical trials, observational, and descriptive studies.

Main Methods:

  • Searched Medline, Embase, Cochrane Library, and CINAHL up to April 2020.
  • Included 25 studies evaluating melatonin for electroencephalogram (EEG), brainstem evoked response audiometry (BAER), and magnetic resonance imaging (MRI).
  • Performed meta-analysis using a fixed-effect model for comparable studies.

Main Results:

  • No significant difference in successful procedure completion for EEG when comparing melatonin to sleep deprivation or chloral hydrate.
  • Higher sedation failure rates were observed with melatonin alone versus melatonin combined with sleep deprivation for EEG.
  • Melatonin demonstrated reduced sleep latency compared to sleep deprivation for EEG.
  • No major adverse events were reported with melatonin use.

Conclusions:

  • While 25 studies were identified and no serious safety concerns emerged, the overall evidence quality is low.
  • Current evidence is insufficient to establish melatonin's efficacy for non-operating room sedation in children.
  • Further high-quality research is needed to confirm melatonin's effectiveness in this population.
Abstract

Keywords:
analgesiaaudiologyneonatologysleepstatistics

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