Melatonin may reduce postoperative delirium, but evidence certainty was low
Surgical trials found lower delirium incidence with melatonin, inconclusive results for ramelteon, and no statistically significant improvements in other recovery measures.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
Melatonin trials showed lower postoperative delirium incidence than control care, but the review rated this evidence as low certainty. Ramelteon did not show a statistically significant benefit. Pain, sedation scores, and hospital stay also did not improve significantly overall. These findings concern older surgical patients and cannot establish a benefit for everyday sleep problems.
This abstract-based explanation is limited by low certainty and substantial variation in several analyses. Follow-up periods are unspecified, and apparent subgroup differences cannot establish which drug or dose is best.
What researchers found
Postoperative delirium in melatonin trials
Reported delirium rates were 22.4% with melatonin versus 31.4% in controls. Certainty was low; the exact postoperative observation period was not reported.
A surgical complication
Delirium involves a sudden, fluctuating disturbance in attention and awareness. The trials assessed its occurrence around surgery, so the main question concerned a postoperative complication rather than sleep quality or a dementia diagnosis.
Drug comparisons need care
The separate analyses supported melatonin more clearly than ramelteon. However, a statistically significant finding for one drug and a nonsignificant finding for another do not establish that the drugs differ in effectiveness.
The original publication
Melatonin or ramelteon for the prevention of postoperative delirium in elderly patients: A systematic review and meta-analysis of randomized clinical trials.
Borges JMMF, Mendes RG, Silva RP et al.
J Clin Anesth · 2026
- PubMed ID
- 41702325
- Record checked
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