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Relationship among melatonin, postoperative delirium, and postoperative cognitive dysfunction.

Shanshan Mu1, Yan Wu1, Anshi Wu1

  • 1Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

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Increased melatonin levels after surgery may elevate the risk of postoperative delirium (POD), while its association with postoperative cognitive dysfunction (POCD) remains unclear. POD itself may increase the likelihood of developing POCD.

Keywords:
6-sulfatoxymelatonin (6-SMT)Melatonincreatininepostoperative cognitive dysfunction (POCD)postoperative delirium (POD)

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Area of Science:

  • Anesthesiology
  • Neuroscience
  • Gerontology

Background:

  • Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are common central nervous system complications following surgery.
  • Melatonin is known for its neuroprotective properties and influence on cognitive function.

Purpose of the Study:

  • To investigate the relationship between melatonin levels and the incidence of POD and POCD.
  • To explore the potential role of melatonin as a risk factor for these postoperative neurological dysfunctions.

Main Methods:

  • 120 patients undergoing elective non-cardiac surgery were monitored for POD using the Confusion Assessment Method (CAM).
  • Neuropsychological tests assessed POCD before and 7 days after surgery.
  • Urine samples measured 6-sulfatoxymelatonin (6-SMT), a melatonin metabolite, and the 6-SMT/creatinine ratio (M/C).

Main Results:

  • The incidence of POD and POCD was 7% and 44%, respectively.
  • While M/C levels did not differ between POD and non-POD groups, significant changes in M/C rates were observed on postoperative days 1 and 7.
  • Higher M/C rate changes correlated with increased POD incidence, suggesting increased melatonin may be a risk factor.

Conclusions:

  • Elevated melatonin levels post-surgery may be a risk factor for developing postoperative delirium (POD).
  • No significant correlation was found between melatonin levels and postoperative cognitive dysfunction (POCD).
  • POD may serve as a risk factor for the development of POCD.