title: Impact of Melatonin on Sleep and Pain After Total Knee Arthroplasty Under Regional Anesthesia With Sedation: A Double-Blind, Randomized, Placebo-Controlled Pilot Study.
abstract: This pilot study explores sleep disruption after total knee arthroplasty and the impact of melatonin on sleep and postoperative pain. Sleep time was decreased on the last preoperative night and first two postoperative nights. Sleep efficiency was decreased on all three postoperative nights. Compared to placebo, melatonin increased sleep efficiency by 4.4% (mean; 95% CI -1.6, 10.4; P=0.150) and sleep time by 29 min (mean; 95% CI -2.0, 60.4; P=0.067). Melatonin appeared to have no effect on subjective sleep quality or daytime sleepiness, pain at rest or pain with standardized activity. In conclusion, sleep quality is impaired after total knee arthroplasty and exogenous melatonin does not appear to improve postoperative sleep or pain to a significant degree.
authors.affiliation: Hospital for Special Surgery, New York, New York.
authors.forename: Meghan A
authors.initials: MA
authors.lastname: Kirksey
authors.affiliation: Hospital for Special Surgery, New York, New York.
authors.forename: Daniel
authors.initials: D
authors.lastname: Yoo
authors.affiliation: Hospital for Special Surgery, New York, New York; Paracelsus Medical University, Salzburg, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Danninger
authors.affiliation: Hospital for Special Surgery, New York, New York; Paracelsus Medical University, Salzburg, Austria.
authors.forename: Ottokar
authors.initials: O
authors.lastname: Stundner
authors.affiliation: George Washington University, Washington, DC.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Hospital for Special Surgery, New York, New York.
authors.forename: Stavros G
authors.initials: SG
authors.lastname: Memtsoudis
mesh_terms: D000368:Aged; D000765:Anesthesia, Conduction; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D002492:Central Nervous System Depressants / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D010865:Pilot Projects; D012890:Sleep / Q000187:drug effects; D012893:Sleep Wake Disorders / Q000188:drug therapy* / Q000209:etiology
chemical_list: D002492:Central Nervous System Depressants; D008550:Melatonin
keywords: actigraphy; arthroplasty; melatonin; pain; sleep