title: POTENTIAL USE OF MELATONIN IN PROCEDURAL ANXIETY AND PAIN IN CHILDREN UNDERGOING BLOOD WITHDRAWAL.
abstract: The recognition of the value of pain, especially in the pediatric population, has increased over the last decade. It is known that pain-related anxiety can increase perceived pain intensity. There are several different approaches to the treatment of pre-procedural anxiety and procedural pain in children. Melatonin, a neurohormone with the profile of a novel hypnotic-anaesthetic agent, plays an important role in anxiolysis and analgesia. This study investigated the effects of oral melatonin premedication to reduce anxiety and pain in children having blood samples taken. The investigations were carried out on 60 children, aged 1-14 years, divided into 2 equal groups. Using a computer-generated randomization schedule, patients were given either melatonin orally (0.5 mg/kg BW, max 5 mg) or placebo 30 min before blood draw. Pre-procedural anxiety was assessed using the scale from the Childrens Anxiety and Pain Scales, while procedural pain used the Face, Legs, Activity, Cry and Consolability assessment tool for children under the age of 3 years, Faces Pain Scale-Revised for children aged 3-8 years and Numeric Rating Scale for children over the age of 8 years. Oral administration of melatonin before the blood withdrawal procedure significantly reduced both anxiety (p<0.0005) and pain levels than placebo (p<0.0002 for children under 3 years and p<0.0039 for children over 3 years). These data support the use of melatonin for taking blood samples due to its anxiolytic and analgesic properties. Further studies are needed to support the routine use of melatonin to alleviate anxiety and pain in pediatric patients having blood samples taken.
authors.affiliation: Neonatal Intensive Care Unit, Department of Paediatrics, University of Messina, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Marseglia
authors.affiliation: Unit of Paediatric Genetics and Immunology, Department of Paediatrics, University of Messina, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Manti
authors.affiliation: Neonatal Intensive Care Unit, Department of Paediatrics, University of Messina, Italy.
authors.forename: G
authors.initials: G
authors.lastname: D'Angelo
authors.affiliation: Unit of Paediatric Genetics and Immunology, Department of Paediatrics, University of Messina, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Arrigo
authors.affiliation: Unit of Paediatric Genetics and Immunology, Department of Paediatrics, University of Messina, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Cuppari
authors.affiliation: Unit of Paediatric Genetics and Immunology, Department of Paediatrics, University of Messina, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Salpietro
authors.affiliation: Neonatal Intensive Care Unit, Department of Paediatrics, University of Messina, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Gitto
mesh_terms: D059787:Acute Pain / Q000209:etiology / Q000517:prevention & control*; D000284:Administration, Oral; D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use*; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008550:Melatonin / Q000008:administration & dosage / Q000627:therapeutic use*; D010147:Pain Measurement; D058748:Pain Perception / Q000187:drug effects; D018962:Phlebotomy / Q000009:adverse effects* / Q000523:psychology; D011292:Premedication; D011677:Punctures / Q000009:adverse effects / Q000523:psychology
chemical_list: D018712:Analgesics, Non-Narcotic; D014151:Anti-Anxiety Agents; D000975:Antioxidants; D008550:Melatonin