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Melatonin and melatonergic agents for the prevention of postoperative delirium: A meta-analysis of randomized placebo-controlled trials
- Source :
- Asian Journal of Surgery, Vol 45, Iss 1, Pp 27-32 (2022)
- Publication Year :
- 2022
- Publisher :
- Elsevier, 2022.
-
Abstract
- Summary Studies on melatonin and melatonergic agents (MMA) for the prevention of postoperative delirium (POD) have produced inconsistent findings. We conducted a meta-analysis to assess the effect of perioperative MMA on the prevention for POD. This meta-analysis is registered in the PROSPERO (CRD42020164900). We searched PubMed, Embase, and Cochrane Library through August 1, 2020 to identify randomized placebo-controlled trials (RCTs) that assessed MMA for the prevention for POD in adult patients undergoing surgery. The primary outcome was POD. Relative risk (RR) with 95% confidence interval (CI) was pooled using a random-effects model. Nine RCTs with 1452 patients were included. The incidence of POD was 23.8% (173/726) and 24.4% (177/726) in the MMA and placebo groups, respectively. Compared with placebo, MMA did not reduce the occurrence of POD (9 trails, 1452 patients, RR 0.93, 95% CI 0.70–1.24), with modest heterogeneity (I2 = 40%). Sensitivity analyses suggested that MMA also did not reduce the occurrence of POD in elderly patients (age ≥65 years) (6 trails, 810 patients, RR 0.71, 95% CI 0.38–1.32), patients given melatonin (4 trails, 806 patients, RR 0.78, 95% CI 0.43–1.41) or ramelteon (4 trails, 345 patients, RR 0.89, 95% CI 0.44–1.78), and patients undergoing general anesthesia (4 trails, 681 patient, RR 1.02, 95% CI 0.82–1.28). Based on the current evidence, perioperative MMA may have no effect on the prevention of POD.
- Subjects :
- Adult
medicine.medical_specialty
RD1-811
Cochrane Library
Anesthesia, General
Placebo
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Aged
Randomized Controlled Trials as Topic
Melatonin
business.industry
Incidence (epidemiology)
Incidence
Delirium
Perioperative
Confidence interval
Meta-analysis
030220 oncology & carcinogenesis
Relative risk
030211 gastroenterology & hepatology
Surgery
medicine.symptom
business
Subjects
Details
- Language :
- English
- ISSN :
- 10159584
- Volume :
- 45
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Asian Journal of Surgery
- Accession number :
- edsair.doi.dedup.....8de091c8f1c3f8f11c43ffc3a7e6f93a