• Yunxia Fan, Liang Yuan, Muhuo Ji, Jianjun Yang, and Dapeng Gao.
• Department of Anesthesiology, Jintan Hospital, Jiangsu University, Changzhou, China.
• J Clin Anesth. 2017 Jun 1; 39: 77-81.

Study ObjectiveThe purpose of the present study was to investigate whether exogenous melatonin supplementation could ameliorate early postoperative cognitive decline (POCD) in aged patients undergoing hip arthroplasty with spinal anesthesia.DesignProspective cohort study.SettingDepartment of Anesthesiology, Jinling Hospital, Nanjing University, Nanjing, China.PatientsOne hundred and thirty-nine patients with ASA I-III, older than 65yr of age (mean age: 74.5±5.5; gender: male 53 and female 86), scheduled for hip arthroplasty were included in the present study.InterventionsPatients were randomized to receive 1mg oral melatonin or placebo daily 1h before bedtime one day before surgery and for another 5 consecutive days postoperatively.MeasurementsThe subject assessment, including Mini-Mental State Examination (MMSE) score, subjective sleep quality, general well-being, postoperative fatigue, and visual analogue scale for pain were evaluated pre-operatively and at days 1, 3, 5, and 7 after surgery.Main ResultsThe MMSE score in the control group decreased significantly after surgery when compared with its own preoperative value or the melatonin group at days 1, 3, and 5. However, the MMSE score in the melatonin group remained unchanged during the 7days of monitoring. In addition, significant postoperative impairments of subjective sleep quality, general well-being, and fatigue were found in the control group when compared with the melatonin group.ConclusionPeroperative melatonin supplementation might improve early POCD, suggesting restoration of normal circadian function with good sleep quality may be one of the key factors in preventing or treating POCD.Copyright © 2017 Elsevier Inc. All rights reserved.

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