Melatonin is a chemical produced by the pineal gland of the brain. It is dispersed throughout the body and has multiple functions. These include regulation of circadian rhythms, adjustment of seasonal changes, antioxidant activity, blocking cancer, anti-inflammatory properties, and anticonvulsant effects. Common use is for sleep disorders and jet lag. It works as a sedative and relieves anxiety. Melatonin relieves seizures by facilitating the action of gamma-amino butyric acid (GABA), and is used in adults for chronic pain.
This chemical works in relieving anxiety if given before general anesthesia. It can be used orally and sublingualy before surgery. The peak effect of melatonin is 60 minutes after oral use. Blood levels decline over 4 hours, and no serious side effects are reported.
Melatonin is important in the relief of pain. The mechanism of action is not known at this time, except inflammatory pain seems to be relieved by the inhibition of NO (nitric oxide) production. It may work for chronic pain only. In a study of fibromyalgia, melatonin (given 3 mg orally for 4 weeks, 30 min before sleep) improved sleep and relieved the number of pain trigger points. Melatonin 3 mg in inflammatory bowel syndrome relieved abdominal pain, bloating, and rectal pain in this study.
In pediatrics, melatonin has been useful in treating anxiety-related sleep disorders and it may be useful for children undergoing anesthetic procedures. However, sufficient properties have not been found to make it useful as a general anesthetic. It is used in children who must undergo diagnostic procedures requiring sedation (dose 5-20 mg depending on age). Melatonin is useful in some studies of children undergoing EEGs, and it may be a good alternative to the traditionally used chloral hydrate.
CONCLUSION: Melatonin is a natural remedy which may be used for chronic pain in adults and as a sedation for children before a medical test or as a preoperative medication.
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