Melatonin: Is It Suitable for Use in Anesthesia?

Main Article Content

Kornnika Yangan


Melatonin is a hormone secreted from pineal gland.
It involves in the regulation of circadian rhythmicity and
seasonality in human and animals. It is widely used for the
treatment of insomnia and jet lag.
Melatonin has effects on anti-carcinogenesis and its
metastasis, antihypertension, anti-free radicals that protect
tissue and cells from oxidative stress, and inhibition of
white blood cell aggregation results in anti-inflammatory
Melatonin has 85% first-pass effect, 1-hour half-life
and renal clearance. Long administration of this hormone
yields adverse effects such as daytime yawning, dozing,
headache, dizziness, and short-term depression.
Surgery and anesthesia can interfere circadian rhythm.
These delay melatonin secretion at night. Exogenous
melatonin helps sleep onset latency back to normal as
soon as possible. In addition, it prevents delirium and
problems of postoperative cognitive dysfunction in early
24 hour without loss of orientation and affective function.
Though melatonin has anxiolytic and hypnotic
properties, its efficacy is not sufficient enough as an
alternative anesthetics, but an adjuvant for premedication,
general anesthesia, and pain relief. Melatonin differs from
midazolam in term of its early recovery time and less
postoperative agitation. It decreases the amount of
propofol, thopental and ketamine resulting in rapid
Remarkably, the American Food and Drug Administration
have not yet approved melatonin, except Ramelteon
(Rozerem®) for the treatment of insomnia.

Article Details

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