Melatonin for pre-medication in children: a systematic review

source extracted confidence: high 2026-04-09
#adult #anesthesia #anti-anxiety-agents #anxiety #child

Melatonin for pre-medication in children: a systematic review

Mellor et al., 2022 | BMC Pediatr | Systematic Review

Citation

Mellor Katie, Papaioannou Diana, ... Deery Chris. Melatonin for pre-medication in children: a systematic review. BMC Pediatr. 2022-Feb-24;22(1):107. doi:10.1186/s12887-022-03149-w

Abstract

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.

Key Findings

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.

Outcomes Measured

  • anxiety

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition sleep

MeSH Terms

  • Adult
  • Anesthesia
  • Anti-Anxiety Agents
  • Anxiety
  • Child
  • Humans
  • Hypnotics and Sedatives
  • Melatonin

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: melatonin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09