Impact of Melatonin on Sleep and Pain After Total Knee Arthroplasty Under Regional Anesthesia With Sedation: A Double-Blind, Randomized, Placebo-Controlled Pilot Study

• Published in: The Journal of arthroplasty Vol. 30; no. 12; pp. 2370 - 2375
• Main Authors: Kirksey, Meghan A., MD, PhD, Yoo, Daniel, MB, Danninger, Thomas, MD, Stundner, Ottokar, MD, Ma, Yan, PhD, Memtsoudis, Stavros G., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2015
• Subjects: actigraphy; Aged; Anesthesia, Conduction; arthroplasty; Arthroplasty, Replacement, Knee - adverse effects; Central Nervous System Depressants - pharmacology; Central Nervous System Depressants - therapeutic use; Double-Blind Method; Female; Humans; Male; melatonin; Melatonin - pharmacology; Melatonin - therapeutic use; Middle Aged; Orthopedics; pain; Pain, Postoperative - drug therapy; Pilot Projects; sleep; Sleep - drug effects; Sleep Wake Disorders - drug therapy; Sleep Wake Disorders - etiology; sleep; pain; actigraphy; melatonin; arthroplasty
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2015.06.034

Abstract This pilot study explores sleep disruption after total knee arthroplasty and the impact of melatonin on sleep and postoperative pain. Sleep time was decreased on the last preoperative night and first two postoperative nights. Sleep efficiency was decreased on all three postoperative nights. Compared to placebo, melatonin increased sleep efficiency by 4.4% (mean; 95% CI − 1.6, 10.4; P = 0.150) and sleep time by 29 min (mean; 95% CI − 2.0, 60.4; P = 0.067). Melatonin appeared to have no effect on subjective sleep quality or daytime sleepiness, pain at rest or pain with standardized activity. In conclusion, sleep quality is impaired after total knee arthroplasty and exogenous melatonin does not appear to improve postoperative sleep or pain to a significant degree.