Melatonin and postoperative delirium: a possible link?

摘要

Melatonin, an indole neurohormone, is the principal secretory product of the pineal gland that is synthesized from tryptophan and released directly into the bloodstream in a circadian pattern governed by the light and dark cycle. It produces hypnotic effects by accelerating sleep initiation and improving sleep maintenance and efficiency. Unlike most hypnotics, melatonin is not associated with significant changes in sleep architecture, hangover effects, substance dependence, or the potential for substance abuse. In addition, melatonin possesses the capacity to resynchronize the human circadian rhythm, and it may play a role in physiological adaptation to jet lag and shift work. Considering its hypnotic and chronobiotic properties, melatonin may also serve a role in the perioperative setting when the patient's sleeping patterns are likely to be disturbed.