Marseglia Lucia, D'Angelo Gabriella, Manti Sara, Aversa Salvatore, Arrigo Teresa, Reiter Russel J, Gitto Eloisa
Neonatal and Paediatric Intensive Care Unit, Department of Paediatrics, University of Messina, Via Consolare Valeria, Messina 98125, Italy.
Unit of Paediatric Genetics and Immunology, Department of Paediatrics, University of Messina, Via Consolare Valeria 1, Messina 98125, Italy.
Int J Mol Sci. 2015 Jan 6;16(1):1209-20. doi: 10.3390/ijms16011209.
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.
外源性褪黑素在多种情况下使用，首要的是用于治疗睡眠障碍和时差反应。然而，褪黑素的催眠、抗伤害感受和抗惊厥特性使这种神经激素具有调节麻醉剂作用的药物特性，这支持了其在成人和儿童麻醉过程不同阶段的潜在用途。鉴于这些特性，已将褪黑素给予接受需要镇静或全身麻醉的诊断程序的儿童，如磁共振成像、听觉脑干反应测试和脑电图检查。有争议的数据支持在接受手术的儿科患者中使用褪黑素作为抗焦虑和抗伤害感受药物。本综述的目的是评估有关褪黑素作为儿童镇痛剂和镇静剂的疗效和安全性的现有证据。褪黑素及其类似物可能在抗伤害感受治疗中发挥作用，并可替代咪达唑仑用于成人和儿童的术前用药，尽管其有效性仍存在争议且现有数据明显不完整。
