Related Experiment Video
Updated: Oct 2, 2025
Author Spotlight: Overcoming Challenges in Drosophila Sleep Measurement Using DAM System
Published on: October 20, 2023
Melatonin for pre-medication in children: a systematic review
Katie Mellor1, Diana Papaioannou1, Anna Thomason1
1School of Health and Related Research, University of Sheffield, Sheffield, UK.
Insights
Melatonin may reduce pre-operative anxiety in children, but evidence is conflicting. While it shows potential benefits like improved emergence behavior and a good safety profile, more research is needed to confirm its efficacy compared to standard treatments.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Evidence-Based Medicine
Background:
- Melatonin's anxiolytic effects are established in adults, but its efficacy in children remains uncertain.
- Previous studies on pre-operative melatonin in pediatric surgical patients have yielded conflicting results.
Purpose of the Study:
- To systematically review the existing literature on the use of melatonin as a pre-operative anxiolytic in pediatric populations.
- To evaluate the efficacy and safety of melatonin compared to placebo or standard pre-medications in children undergoing surgery.
Main Methods:
- A systematic review was conducted using multiple databases (MEDLINE, Embase, Cochrane, Web of Science) and clinical trial registries.
- Eleven studies were included, with no restrictions on comparators or outcomes, assessing anxiety, anesthetic success, sedation, recovery, and safety.
- Significant heterogeneity was noted in melatonin dosing, timing, and outcome assessment measures across studies.
Main Results:
- Conflicting evidence exists regarding melatonin's anxiolytic properties in pediatric pre-operative settings.
- Melatonin demonstrated potential benefits, including reduced sedation, less post-operative excitement, and improved emergence behavior.
- No significant adverse safety events were associated with melatonin, supporting its favorable safety profile. One study noted improved sleep disturbance at two weeks post-surgery.
Conclusions:
- Despite potential advantages, current evidence is insufficient to confirm melatonin's non-inferiority to standard pre-operative medications in pediatric surgery.
- Further rigorous research is required to establish the role of melatonin as an anxiolytic pre-medication in pediatric surgical care.
Background:
Melatonin's effectiveness as an anxiolytic medication has been confirmed in adults; however, its efficacy in a paediatric population is unclear. A number of small studies have assessed its use in children as a pre-operative anxiolytic, with conflicting results.
Methods:
We undertook a systematic review of pre-operative melatonin use in children. Four databases (MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Web of Science), and ' ClinicalTrials.gov ' were searched for ongoing and completed clinical trials of relevance. Citation tracking reference lists and relevant articles were also accessed. The review was unrestricted by comparator or outcomes. Eleven studies were judged eligible for inclusion. There were high levels of heterogeneity in melatonin administration (in terms of dose and timing). Variable outcomes were reported and included: anxiety; anaesthetic success; analgesia; sedation; post-operative recovery; and safety. Outcomes were not always assessed with the same measures.
Results:
Evidence to support melatonin's anxiolytic properties in this setting is conflicting. Melatonin was associated with reduced sedative effects, post-operative excitement and improved emergence behaviour, compared to comparator drugs. One study reported the benefit of melatonin use on sleep disturbance at two weeks post-surgery. No adverse safety events were identified to be significantly associated with melatonin, affirming its excellent safety profile.
Conclusion:
Despite potential advantages, including improved emergence behaviour, based on current evidence we cannot confirm whether melatonin is non-inferior to current "usual care" pre-medications. Further consideration of melatonin as an anxiolytic pre-medication in paediatric surgery is needed.
