The effect of melatonin on delirium incidence in orthopedic patients: a clinical trial study

Introduction: Delirium is an acute psychiatric condition that can lead to very unpleasant consequences in post-operative orthopedics patients. Therefore, extensive studies have been done on the diagnosis, prevention and treatment of cognitive impairment especially delirium in patients admitted to the intensive care unit, orthopedic surgeries, organ transplantation and heart surgery departments. The aim of this study was to determine the efficacy of melatonin on prevention of delirium in orthopedics patients. Materials and methods: The present study was a double-blind randomized clinical trial which was performed on 100 patients admitted to orthopedics department. Patients were randomly divided into two groups to achieve optimal matching, using random numbers table. The first group received sublingual melatonin from the day before the surgery and on days 1, 2 and 3 after the operation, and second group received placebo. All of the two groups were evaluated for delirium on a daily basis (from day before surgery to 3 days later) at a specific and identical hour by a fixed and definite person by using the CAM test. Result: In this study, 100 patients were examined. The results showed that the mean age in the case group was 42.88 years with a standard deviation of 12.53, while the control group was 46.94 years with a standard deviation of 15.42 and there was no significant difference between the two groups according to p =0.152. Also, there was no significant difference in gender and educational level of patients in the two groups. The results of the CAM test showed no significant difference between the two groups on the day before and the first, second and third days after the operation. Conclusion: According to the results of this study, the administration of melatonin did not have an effect on the incidence of delirium in the orthopedics department, but extensive multi-center studies and the use of different doses of the drug could be useful in determining the optimal dose of melatonin.