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麻醉与褪黑素之间的关系:综述

The relationship between anesthesia and melatonin: a review.

作者信息

Guo Rui, Ye Junming, Liao Baozhen, Luo Xin, Rao Panguo

机构信息

Department of Anesthesiology, First Affiliated Hospital of Gannan Medical College, Ganzhou, Jiangxi, China.

Suzhou Medical College of Soochow University, Suzhou, China.

出版信息

Front Pharmacol. 2023 Sep 19;14:1255752. doi: 10.3389/fphar.2023.1255752. eCollection 2023.

Abstract

This comprehensive review delves into the intricate and multifaceted relationship between anesthesia and melatonin, aiming to provide essential insights for perioperative clinical anesthesiologists and stimulate interest in related research. Anesthesia and surgery have the potential to disrupt melatonin secretion, leading to sleep disorders, postoperative neurocognitive dysfunction and other symptoms. In comparison to previous reviews, this review provides a comprehensive summary of the various aspects linking melatonin and anesthesia, going beyond isolated perspectives. It explores the potential benefits of administering melatonin during the perioperative period, including alleviating anxiety, reducing pain, enhancing perioperative sleep quality, as well as demonstrating immunomodulatory and anti-tumor effects, potentially offering significant advantages for cancer surgery patients. Anesthesia and surgery have a significant impact on melatonin secretion, the hormone crucial for maintaining circadian rhythms. These procedures disrupt the normal secretion of melatonin, leading to various adverse effects such as sleep disturbances, pain, and postoperative neurocognitive dysfunction. However, the administration of exogenous melatonin during the perioperative period has yielded promising results. It has been observed that perioperative melatonin supplementation can effectively reduce anxiety levels, improve pain management, enhance the quality of perioperative sleep, and potentially decrease the occurrence of postoperative delirium. In recent years, studies have found that melatonin has the potential to improve immune function and exhibit anti-cancer effects, further underscoring its potential advantages for patients undergoing cancer surgery. In summary, melatonin can serve as an adjuvant drug for anesthesia during the perioperative period. Its administration has demonstrated numerous positive effects, including anti-anxiety properties, sedation, analgesia, improved postoperative sleep, and the potential to reduce the incidence of postoperative delirium. Furthermore, its immune-modulating and anti-tumor effects make it particularly valuable for cancer surgery patients. However, further studies are required to determine the optimal dosage, long-term safety, and potential adverse reactions associated with melatonin administration.

摘要

这篇综述深入探讨了麻醉与褪黑素之间复杂且多方面的关系,旨在为围手术期临床麻醉医生提供重要见解,并激发相关研究兴趣。麻醉和手术可能会干扰褪黑素的分泌,导致睡眠障碍、术后神经认知功能障碍等症状。与以往的综述相比,本综述全面总结了褪黑素与麻醉相关的各个方面,而非局限于单一视角。它探讨了围手术期给予褪黑素的潜在益处,包括缓解焦虑、减轻疼痛、提高围手术期睡眠质量,以及显示出免疫调节和抗肿瘤作用,这可能为癌症手术患者带来显著优势。麻醉和手术对褪黑素分泌有重大影响,而褪黑素是维持昼夜节律的关键激素。这些操作会扰乱褪黑素的正常分泌,导致各种不良反应,如睡眠障碍、疼痛和术后神经认知功能障碍。然而,围手术期给予外源性褪黑素已取得了令人鼓舞的结果。据观察,围手术期补充褪黑素可有效降低焦虑水平、改善疼痛管理、提高围手术期睡眠质量,并可能减少术后谵妄的发生。近年来,研究发现褪黑素具有改善免疫功能和抗癌作用的潜力,这进一步凸显了其对癌症手术患者的潜在优势。总之,褪黑素可作为围手术期麻醉的辅助药物。其应用已显示出许多积极效果,包括抗焦虑特性、镇静、镇痛、改善术后睡眠以及降低术后谵妄发生率的潜力。此外,其免疫调节和抗肿瘤作用使其对癌症手术患者尤为有价值。然而,需要进一步研究来确定褪黑素给药的最佳剂量、长期安全性以及潜在的不良反应。

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