The effect of melatonin on sedation of children undergoing magnetic resonance imaging.
BACKGROUND
Melatonin may induce a natural sleepiness and improve predictability of sedation drugs. We have investigated its clinical value in children sedated for magnetic resonance imaging.


METHODS
In a stratified randomized double-blind study, 98 children received either melatonin or placebo 10 min before they were sedated with a standard oral regimen. Children >5 and <15 kg received chloral hydrate and those >or=15 and <40 kg had a combination of temazepam with droperidol (T&D). The doses of melatonin were 3 and 6 mg, respectively. One observer recorded the time taken to reach criteria for deep sedation, sedation failure and other sedation-related events.


RESULTS
In the chloral hydrate group (n=50) 50% were deeply sedated by 31 min after melatonin and 40 min after placebo (P=0.57). There were zero and 1 failures, respectively. The geometric mean time taken to reach deep sedation was 39 min in both subgroups. In the T&D group (n=48) 50% were deeply sedated by 70 min in both subgroups (two failures in each); geometric mean times were 68 and 71 min, respectively (P=0.58). Children closed their eyes slightly earlier after melatonin (respective geometric means 42 vs 48, P=0.17), and took slightly longer to achieve discharge criteria (146 vs 135, P=0.47).


CONCLUSIONS
In these doses and clinical conditions, melatonin did not contribute to sedation of children.
Sury
M R J
MR
Department of Anaesthesia, Great Ormond Street Hospital for Children NHS Trust, London, UK. surym@gosh.nhs.uk
Fairweather
K
K
D000759:Adjuvants, Anesthesia; D002214:Capsules / Q000032:analysis; D002675:Child, Preschool; D002697:Chloral Hydrate; D004311:Double-Blind Method; D004329:Droperidol; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008550:Melatonin / Q000008:administration & dosage*; D010865:Pilot Projects; D012890:Sleep / Q000187:drug effects; D013693:Temazepam; D013997:Time Factors
D000759:Adjuvants, Anesthesia; D002214:Capsules; D006993:Hypnotics and Sedatives; D002697:Chloral Hydrate; D013693:Temazepam; D008550:Melatonin; D004329:Droperidol