title: Analgesic, anxiolytic and anaesthetic effects of melatonin: new potential uses in pediatrics.
abstract: Exogenous melatonin is used in a number of situations, first and foremost in the treatment of sleep disorders and jet leg. However, the hypnotic, antinociceptive, and anticonvulsant properties of melatonin endow this neurohormone with the profile of a drug that modulates effects of anesthetic agents, supporting its potential use at different stages during anesthetic procedures, in both adults and children. In light of these properties, melatonin has been administered to children undergoing diagnostic procedures requiring sedation or general anesthesia, such as magnetic resonance imaging, auditory brainstem response tests and electroencephalogram. Controversial data support the use of melatonin as anxiolytic and antinociceptive agents in pediatric patients undergoing surgery. The aim of this review was to evaluate available evidence relating to efficacy and safety of melatonin as an analgesic and as a sedative agent in children. Melatonin and its analogs may have a role in antinociceptive therapies and as an alternative to midazolam in premedication of adults and children, although its effectiveness is still controversial and available data are clearly incomplete.
authors.affiliation: Neonatal and Paediatric Intensive Care Unit, Department of Paediatrics, University of Messina, Via Consolare Valeria, Messina 98125, Italy. lmarseglia@unime.it.
authors.forename: Lucia
authors.initials: L
authors.lastname: Marseglia
authors.affiliation: Neonatal and Paediatric Intensive Care Unit, Department of Paediatrics, University of Messina, Via Consolare Valeria, Messina 98125, Italy. gabridangelo@alice.it.
authors.forename: Gabriella
authors.initials: G
authors.lastname: D'Angelo
authors.affiliation: Unit of Paediatric Genetics and Immunology, Department of Paediatrics, University of Messina, Via Consolare Valeria 1, Messina 98125, Italy. saramanti@hotmail.it.
authors.forename: Sara
authors.initials: S
authors.lastname: Manti
authors.affiliation: Neonatal and Paediatric Intensive Care Unit, Department of Paediatrics, University of Messina, Via Consolare Valeria, Messina 98125, Italy. aversalvo@hotmail.com.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Aversa
authors.affiliation: Unit of Paediatric Genetics and Immunology, Department of Paediatrics, University of Messina, Via Consolare Valeria 1, Messina 98125, Italy. tarrigo@unime.it.
authors.forename: Teresa
authors.initials: T
authors.lastname: Arrigo
authors.affiliation: Department of Cellular and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, TX 40729, USA. reiter@uthscsa.edu.
authors.forename: Russel J
authors.initials: RJ
authors.lastname: Reiter
authors.affiliation: Neonatal and Paediatric Intensive Care Unit, Department of Paediatrics, University of Messina, Via Consolare Valeria, Messina 98125, Italy. egitto@unime.it.
authors.forename: Eloisa
authors.initials: E
authors.lastname: Gitto
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D018681:Anesthetics, General / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy; D001927:Brain Diseases / Q000175:diagnosis; D002648:Child; D004569:Electroencephalography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008550:Melatonin / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D005680:gamma-Aminobutyric Acid / Q000378:metabolism
chemical_list: D000700:Analgesics; D018681:Anesthetics, General; D014151:Anti-Anxiety Agents; D005680:gamma-Aminobutyric Acid; D008550:Melatonin