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Melatonin for pre- and postoperative anxiety in adults

Overview of attention for article published in Cochrane database of systematic reviews, April 2015
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (94th percentile)
  • Good Attention Score compared to outputs of the same age and source (77th percentile)

Mentioned by

news
1 news outlet
twitter
24 tweeters
facebook
5 Facebook pages
wikipedia
2 Wikipedia pages
video
1 video uploader

Citations

dimensions_citation
39 Dimensions

Readers on

mendeley
149 Mendeley
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1 CiteULike
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Title
Melatonin for pre- and postoperative anxiety in adults
Published in
Cochrane database of systematic reviews, April 2015
DOI 10.1002/14651858.cd009861.pub2
Pubmed ID
Authors

Melissa V Hansen, Natalie L Halladin, Jacob Rosenberg, Ismail Gögenur, Ann Merete Møller

Abstract

Anxiety in relation to surgery is a well-known problem. Melatonin offers an atoxic alternative to benzodiazepines in ameliorating this condition in the pre- and postoperative period. To assess the effect of melatonin on pre- and postoperative anxiety in adults when comparing melatonin with placebo or when comparing melatonin with benzodiazepines. The following databases were searched on 19 April 2013: CENTRAL, MEDLINE, EMBASE, CINAHL and Web of Science. For ongoing trials and protocols we searched clinicaltrials.gov, Current Controlled Trials and the World Health Organization (WHO) International Clinical Trials Registry Platform. We reran the search in October 2014. We will deal with any studies of interest when we update the review. Randomized, placebo-controlled or standard treatment-controlled, or both, studies that evaluated the effect of preoperatively administered melatonin on preoperative or postoperative anxiety. We included adult patients of both genders (15 to 90 years of age) undergoing any kind of surgical procedure in which it was necessary to use general, regional or topical anaesthesia. Data were extracted independently by two review authors. Data extracted included information about study design, country of origin, number of participants and demographic details, type of surgery, type of anaesthesia, intervention and dosing regimen, preoperative anxiety outcome measures and postoperative anxiety outcome measures. This systematic review identified 12 randomized controlled trials (RCTs) including 774 patients that assessed melatonin for treating preoperative anxiety, postoperative anxiety or both. Four of the 12 studies compared melatonin, placebo and midazolam, whereas the remaining eight studies compared melatonin and placebo only.The quality of the evidence for our primary outcome (melatonin versus placebo for preoperative anxiety) was high. More than half of the included studies had a low risk of selection bias and at least 75% of the included studies had a low risk of attrition, performance and detection bias. Most of the included studies had an unclear risk of reporting bias.Eight out the 10 studies that assessed the effect of melatonin on preoperative anxiety using a visual analogue scale (VAS) (ranging from 0 to 100 mm, higher scores indicate greater anxiety) showed a reduction compared to placebo. The reported estimate of effect (relative effect -13.36, 95% confidence interval (CI) -16.13 to -10.58; high quality evidence) was based on a meta-analysis of seven studies. Two studies did not show any difference between melatonin and placebo. Two studies comparing melatonin with midazolam using a VAS found no evidence of a difference in preoperative anxiety between the two groups (relative effect -1.18, 95% CI -2.59 to 0.23; low quality evidence).Eight studies assessed the effect of melatonin on postoperative anxiety. Four of these studies measuring postoperative anxiety 90 minutes postoperatively using a VAS did not find any evidence of a difference between melatonin and placebo (relative effect -3.71, 95% CI -9.26 to 1.84). Conversely, two studies showed a reduction of postoperative anxiety measured six hours after surgery using the State-Trait Anxiety Inventory (STAI) when comparing melatonin with placebo (relative effect -5.31, 95% CI -8.78 to -1.84; moderate quality evidence). Two studies comparing melatonin with midazolam using a VAS did not find any evidence of a difference between the two groups in postoperative anxiety (relative effect -2.02, 95% CI -5.82 to 1.78). When compared to placebo, melatonin given as premedication (tablets or sublingually) can reduce preoperative anxiety in adults (measured 50 to 100 minutes after administration). Melatonin may be equally as effective as standard treatment with midazolam in reducing preoperative anxiety in adults (measured 50 to 100 minutes after administration). The effect of melatonin on postoperative anxiety (measured 90 minutes and 6 hours after surgery) in adults is mixed but suggests an overall attenuation of the effect compared to preoperatively.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 149 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Korea, Republic of 1 <1%
Australia 1 <1%
United Kingdom 1 <1%
Canada 1 <1%
Spain 1 <1%
United States 1 <1%
Unknown 143 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 33 22%
Researcher 19 13%
Student > Ph. D. Student 17 11%
Student > Bachelor 13 9%
Student > Doctoral Student 9 6%
Other 34 23%
Unknown 24 16%
Readers by discipline Count As %
Medicine and Dentistry 58 39%
Nursing and Health Professions 13 9%
Psychology 9 6%
Pharmacology, Toxicology and Pharmaceutical Science 8 5%
Unspecified 6 4%
Other 25 17%
Unknown 30 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 30. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 January 2020.
All research outputs
#653,922
of 15,124,215 outputs
Outputs from Cochrane database of systematic reviews
#1,865
of 11,111 outputs
Outputs of similar age
#12,955
of 226,881 outputs
Outputs of similar age from Cochrane database of systematic reviews
#53
of 235 outputs
Altmetric has tracked 15,124,215 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,111 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 22.7. This one has done well, scoring higher than 83% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 226,881 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 235 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 77% of its contemporaries.