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Melatonin or its analogs as premedication to prevent emergence agitation in children: a systematic review and meta-analysis.
- Source :
- BMC Anesthesiology; 11/30/2023, Vol. 23 Issue 1, p1-11, 11p
- Publication Year :
- 2023
-
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. [ABSTRACT FROM AUTHOR]
- Subjects :
- ONLINE information services
MEDICAL databases
GENERAL anesthesia
ANESTHESIA
META-analysis
MEDICAL information storage & retrieval systems
CONFIDENCE intervals
SYSTEMATIC reviews
AGITATION (Psychology)
MELATONIN
TREATMENT effectiveness
RESEARCH funding
DESCRIPTIVE statistics
MEDLINE
MIDAZOLAM
PREANESTHETIC medication
EVALUATION
CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 14712253
- Volume :
- 23
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 173922729
- Full Text :
- https://doi.org/10.1186/s12871-023-02356-x