Postoperative Delirium and Melatonin Levels in Elderly Patients


Hidetaka Shigeta, Akihiro Yasui, Yuji Nimura, Nobuo Machida, Moto-o Kageyama, Masakazu Miura, Masafumi Menjo, Kyoji Ikeda



The American Journal of Surgery 182 (2001) 



Background:  melatonin, a hormone produced in the pineal gland, is involved in circadian rhythms and the sleep-wake cycle. Postoperative delirium is encountered frequently in elderly patients after major surgery; whether changes in the pattern of melatonin secretion are associated is unclear.

Methods: plasma samples were obtained every 2 hours from 19 patients without delirium and 10 with delirium after major abdominal surgery. Postoperative delirium was determined using the Confusion Assessment Method in the Practice Guideline of the American Psychiatric Association.

Results: all patients without delirium showed nearly identical preoperative and postoperative melatonin secretion for 24 hours, although peak values were significantly lower in patients more than 80 years old (7.2 ±2.3 pg/mL) than in patients younger than 80 years (24.4 ± 4.1 pg/mL, P = 0.022). Patients with delirium showed two different abnormal postoperative patterns: in 5 patients without complications, melatonin levels were lower than preoperative values (11.0 ± 5.8 versus 6.5 ± 4.2 pg/mL, P = 0.079);  in 5 patients with complications, melatonin levels were markedly increased (21.1 ± 4.5 versus 58.8 ± 12.4 pg/mL, P = 0.043).

Conclusions:  abnormal melatonin secretion may be involved in postoperative sleep disturbances, which triggered delirium in elderly patients.



letteratura_delirium_sonno pz critico

A new frontier in critical care: saving the injuried brain.

Link veloci

Gestire il dolore

ico-flowchartdoloreFlowchart dolore

Gestire la sedazione

ico-flowchart-sedaz-agitFlowchart sedaz/agitaz

Gestire il delirium

ico-flowchart-deliriumFlowchart Delirium
ico-manuale-cam-icuManuale CAM-ICU
ico-schedalavoro-cam-icuScheda di lavoro CAM-ICU


Questo sito è stato realizzato grazie al contributo di:


Finanziamento per la Ricerca Indipendente
(Decreto DGS 13456 del 22 dicembre 2010)

Design by Pixelsparadise