Melatonin or its analogs as premedication to prevent emergence agitation in children: a systematic review and meta-analysis
Abstract Background Emergence agitation (EA) is a prevalent complication in children following general anesthesia. Several studies have assessed the relationship between melatonin or its analogs and the incidence of pediatric EA, yielding conflicting results. This meta-analysis aims to assess the ef...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-11-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-023-02356-x |
| _version_ | 1797414158197587968 |
|---|---|
| author | Dongni Zhang Xiaotong Jia Duomao Lin Jun Ma |
| author_facet | Dongni Zhang Xiaotong Jia Duomao Lin Jun Ma |
| author_sort | Dongni Zhang |
| collection | DOAJ |
| description | Abstract Background Emergence agitation (EA) is a prevalent complication in children following general anesthesia. Several studies have assessed the relationship between melatonin or its analogs and the incidence of pediatric EA, yielding conflicting results. This meta-analysis aims to assess the effects of premedication with melatonin or its analogs on preventing EA in children after general anesthesia. Methods PubMed, EMBASE, the Cochrane Library, ProQuest Dissertations & Theses Global, Web of Science, CNKI, Wanfang Data, clinicaltrials.gov, and WHO International Clinical Trials Registry Platform were searched until 25 November 2022. We included randomized controlled trials that assessed EA in patients less than 18 years old who underwent general anesthesia. We excluded studies that did not use a specific evaluation to assess EA. Results Nine studies (951 participants) were included in this systematic review. Melatonin significantly reduced the incidence of EA compared with placebos (risk ratio 0.40, 95% CI 0.26 to 0.61, P < 0.01) and midazolam (risk ratio 0.48, 95% CI 0.32 to 0.73, P < 0.01). Dexmedetomidine remarkably decreased the incidence of EA compared with melatonin (risk ratio 2.04, 95% CI 1.11 to 3.73, P = 0.02). Conclusions Melatonin premedication significantly decreases the incidence of EA compared with placebos and midazolam. Dexmedetomidine premedication has a stronger effect than melatonin in preventing EA. Nevertheless, further studies are warranted to reinforce and validate the conclusion on the efficacy of melatonin premedication in mitigating EA in pediatric patients. |
| first_indexed | 2024-03-09T05:29:04Z |
| format | Article |
| id | doaj.art-29b49ea608eb4a0387f8d54285f4fcda |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-09T05:29:04Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-29b49ea608eb4a0387f8d54285f4fcda2023-12-03T12:34:07ZengBMCBMC Anesthesiology1471-22532023-11-0123111110.1186/s12871-023-02356-xMelatonin or its analogs as premedication to prevent emergence agitation in children: a systematic review and meta-analysisDongni Zhang0Xiaotong Jia1Duomao Lin2Jun Ma3Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Anesthesiology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Anesthesiology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Anesthesiology, Beijing Anzhen Hospital, Capital Medical UniversityAbstract Background Emergence agitation (EA) is a prevalent complication in children following general anesthesia. Several studies have assessed the relationship between melatonin or its analogs and the incidence of pediatric EA, yielding conflicting results. This meta-analysis aims to assess the effects of premedication with melatonin or its analogs on preventing EA in children after general anesthesia. Methods PubMed, EMBASE, the Cochrane Library, ProQuest Dissertations & Theses Global, Web of Science, CNKI, Wanfang Data, clinicaltrials.gov, and WHO International Clinical Trials Registry Platform were searched until 25 November 2022. We included randomized controlled trials that assessed EA in patients less than 18 years old who underwent general anesthesia. We excluded studies that did not use a specific evaluation to assess EA. Results Nine studies (951 participants) were included in this systematic review. Melatonin significantly reduced the incidence of EA compared with placebos (risk ratio 0.40, 95% CI 0.26 to 0.61, P < 0.01) and midazolam (risk ratio 0.48, 95% CI 0.32 to 0.73, P < 0.01). Dexmedetomidine remarkably decreased the incidence of EA compared with melatonin (risk ratio 2.04, 95% CI 1.11 to 3.73, P = 0.02). Conclusions Melatonin premedication significantly decreases the incidence of EA compared with placebos and midazolam. Dexmedetomidine premedication has a stronger effect than melatonin in preventing EA. Nevertheless, further studies are warranted to reinforce and validate the conclusion on the efficacy of melatonin premedication in mitigating EA in pediatric patients.https://doi.org/10.1186/s12871-023-02356-xEmergence agitationMelatoninPediatrics |
| spellingShingle | Dongni Zhang Xiaotong Jia Duomao Lin Jun Ma Melatonin or its analogs as premedication to prevent emergence agitation in children: a systematic review and meta-analysis BMC Anesthesiology Emergence agitation Melatonin Pediatrics |
| title | Melatonin or its analogs as premedication to prevent emergence agitation in children: a systematic review and meta-analysis |
| title_full | Melatonin or its analogs as premedication to prevent emergence agitation in children: a systematic review and meta-analysis |
| title_fullStr | Melatonin or its analogs as premedication to prevent emergence agitation in children: a systematic review and meta-analysis |
| title_full_unstemmed | Melatonin or its analogs as premedication to prevent emergence agitation in children: a systematic review and meta-analysis |
| title_short | Melatonin or its analogs as premedication to prevent emergence agitation in children: a systematic review and meta-analysis |
| title_sort | melatonin or its analogs as premedication to prevent emergence agitation in children a systematic review and meta analysis |
| topic | Emergence agitation Melatonin Pediatrics |
| url | https://doi.org/10.1186/s12871-023-02356-x |
| work_keys_str_mv | AT dongnizhang melatoninoritsanalogsaspremedicationtopreventemergenceagitationinchildrenasystematicreviewandmetaanalysis AT xiaotongjia melatoninoritsanalogsaspremedicationtopreventemergenceagitationinchildrenasystematicreviewandmetaanalysis AT duomaolin melatoninoritsanalogsaspremedicationtopreventemergenceagitationinchildrenasystematicreviewandmetaanalysis AT junma melatoninoritsanalogsaspremedicationtopreventemergenceagitationinchildrenasystematicreviewandmetaanalysis |