SynthesisBMJ open2023
Does melatonin administration reduce the incidence of postoperative delirium in adults? Systematic review and meta-analysis.
Synthesis in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Association Between Perioperative Sleep Disorders and Post-Operative Delirium in Cardiac Surgeries: A Systematic Review and Meta-Analysis.Journal of sleep research · 2026Pooled it
- Pooled it
- Prophylactic effect of intraoperative sodium oxybate on postoperative delirium in older patients undergoing major orthopedic surgery: a randomized clinical trial.BMC medicine · 2025Trial
- Melatonin for preventing postoperative delirium in elderly patients: A multicenter randomized placebo-controlled pilot study.Medicine · 2025Trial
- Nasal splinting and mouth breathing training reduce emergence delirium after endoscopic sinus surgery: a randomized controlled trial.BMC anesthesiology · 2023Trial
- Encephalopathy in mechanically ventilated adult patients in the intensive care unit: the role of β-Lactam overdosing.Scientific reports · 2026Article
- Effect of Remimazolam on Postoperative Delirium in Elderly Surgical Patients: A Critical Review of Pharmacological Mechanisms and Clinical Evidence.Drug design, development and therapy · 2026Review
- Ketamine and melatonin for the prevention of postoperative delirium in patients with colorectal cancer: a feasibility study.Perioperative medicine (London, England) · 2025Article
- Effect of hospital-acquired complications on hospital length of stay and cost for older adults after a hip fracture in New South Wales, Australia.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Article
- Melatonin: A Review of the Evidence for Use in Hospital Settings.Pharmacology research & perspectives · 2025Review
- Postoperative neurocognitive disorders in the elderly: how can we stop the harm? A literature review.Frontiers in medicine · 2025Review
- Causal Associations Between Sleep Traits and Delirium: A Bidirectional Two-Sample Mendelian Randomization Study.Nature and science of sleep · 2024Article
- The relationship between anesthesia and melatonin: a review.Frontiers in pharmacology · 2023Review
- The Potential Value of Systemic Inflammation Response Index on Delirium After Hip Arthroplasty Surgery in Older Patients: A Retrospective Study.International journal of general medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
Postoperative delirium (POD) is common. It is associated with increased morbidity and mortality. Many cases may be preventable and melatonin offers promise as a preventative agent.
objectiveThis systematic review provides an up-to-date synthesis of the evidence on the effect of melatonin in preventing POD.
designA systematic search of randomised controlled trials of melatonin in POD was run across multiple databases (EMBASE, MEDLINE, CINAHL, PsycINFO) and a clinical trials registry (ClinicalTrials.org) (1 January 1990 to 5 April 2022). Studies examining the effects of melatonin on POD incidence in adults are included. Risk of bias was assessed using the Cochrane risk of bias 2 tool. OUTCOME MEASURES: The primary outcome is POD incidence. Secondary outcomes are POD duration and length of hospital stay. Data synthesis was undertaken using a random-effects meta-analysis and presented using forest plots. A summary of methodology and outcome measures in included studies is also presented.
resultsEleven studies, with 1244 patients from a range of surgical specialties were included. Seven studies used melatonin, in variable doses, and four used ramelteon. Eight different diagnostic tools were used to diagnose POD. Time points for assessment also varied. Six studies were assessed as low risk of bias and five as some concern. The combined OR of developing POD in the melatonin groups versus control was 0.41 (95% CI 0.21 to 0.80, p=0.01).
conclusionThis review found that melatonin may reduce the incidence of POD in adults undergoing surgery. However, included studies displayed inconsistency in their methodology and outcome reporting. Further work to determine the optimum regime for melatonin administration, along with consensus of how best to evaluate results, would be beneficial. PROSPERO REGISTRATION NUMBER: CRD42021285019.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.