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Analgesic Efficacy of Melatonin: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials

by Si Nae Oh 1,2, Seung-Kwon Myung 3,4,5,* and Hyun Jung Jho 6
1
Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea
2
Department of Medicine, Yonsei University Graduate School, Seoul 03722, Korea
3
Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang 10408, Korea
4
Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, Goyang 10408, Korea
5
Department of Family Medicine and Center for Cancer Prevention and Detection, Hospital, National Cancer Center, Goyang 10408, Korea
6
Palliative Care Clinic, Hospital, National Cancer Center, Goyang 10408, Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(5), 1553; https://doi.org/10.3390/jcm9051553
Received: 12 April 2020 / Revised: 13 May 2020 / Accepted: 19 May 2020 / Published: 21 May 2020
(This article belongs to the Section Anesthesiology)
Previous systematic reviews and meta-analyses of randomized controlled trials have reported controversial findings regarding the effects of melatonin on pain reduction. The aim of this study was to evaluate the efficacy of melatonin on pain among adults using a meta-analysis of randomized, double-blind, placebo-controlled trials (RDBPCTs). PubMed, EMBASE, the Cochrane Library, and the bibliographies of relevant articles were searched up to February 2020. Two of the authors independently evaluated eligibility of the studies based on the pre-determined criteria and extracted data. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) for the pain score change were calculated using a random-effects meta-analysis. Out of 463 that met the initial criteria, a total of 30 trials, which involved 1967 participants with 983 in an intervention group and 984 in a control group, were included in the final analysis. In a random-effects meta-analysis, the use of melatonin reduced chronic pain in all the trials (5 studies, SMD −0.65, 95% CI −0.96 to −0.34, I2 = 57.2%) and high-quality trials (4 studies, SMD −0.62, 95% CI −1.01 to −0.23, I2 = 49.3%). Moreover, the use of melatonin significantly reduced acute postoperative pain (11 studies, SMD −0.82, 95% CI −1.40 to −0.25, I2 = 93.0%). However, the subgroup meta-analysis of high-quality RDBPCTs showed no significant association between them (6 studies, SMD −0.21, 95 % CI −0.66 to 0.24, I2 = 82.4%). The current study suggests that melatonin might be used in treatment of chronic pain, while there is no sufficient evidence for acute postoperative or procedural pain. Further trials are warranted to confirm its analgesic effect. View Full-Text
Keywords: melatonin; pain; analgesia; human; meta-analysis melatonin; pain; analgesia; human; meta-analysis
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Oh, S.N.; Myung, S.-K.; Jho, H.J. Analgesic Efficacy of Melatonin: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials. J. Clin. Med. 2020, 9, 1553.

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