{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T20:19:48Z","timestamp":1793996388488,"version":"4.8.0"},"reference-count":40,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Anesthesia"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.jclinane.2026.112151","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T22:08:45Z","timestamp":1771279725000},"page":"112151","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"special_numbering":"C","title":["Melatonin or ramelteon for the prevention of postoperative delirium in elderly patients: A systematic review and meta-analysis of randomized clinical trials"],"prefix":"10.1016","volume":"110","author":[{"given":"Jo\u00e3o M\u00e1rio Mira Furquim","family":"Borges","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphaela Gomes","family":"Mendes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafaela Pereira","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique Baggio","family":"Pivetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Lopes","family":"Miranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela","family":"Alles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana Souza","family":"Nascimento","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jclinane.2026.112151_bb0005","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000041615","article-title":"Melatonin for preventing postoperative delirium in elderly patients: a multicenter randomized placebo-controlled pilot study","volume":"104","author":"Khaled","year":"2025","journal-title":"Medicine (Baltimore)"},{"key":"10.1016\/j.jclinane.2026.112151_bb0010","doi-asserted-by":"crossref","DOI":"10.1186\/s12877-019-1297-6","article-title":"Melatonin for the prevention of postoperative delirium in older adults: a systematic review and meta-analysis","volume":"19","author":"Campbell","year":"2019","journal-title":"BMC Geriatr"},{"key":"10.1016\/j.jclinane.2026.112151_bb0015","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1001\/jama.1996.03530350034031","article-title":"Precipitating factors for delirium in hospitalized elderly persons: predictive model and interrelationship with baseline vulnerability","volume":"275","author":"Inouye","year":"1996","journal-title":"JAMA"},{"key":"10.1016\/j.jclinane.2026.112151_bb0020","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.jpsychores.2011.06.001","article-title":"A longitudinal study of motor subtypes in delirium: relationship with other phenomenology, etiology, medication exposure and prognosis","volume":"71","author":"Meagher","year":"2011","journal-title":"J Psychosom Res"},{"key":"10.1016\/j.jclinane.2026.112151_bb0025","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1007\/s00134-009-1397-4","article-title":"Sleep and delirium in ICU patients: a review of mechanisms and manifestations","volume":"35","author":"Figueroa-Ramos","year":"2009","journal-title":"Intensive Care Med"},{"key":"10.1016\/j.jclinane.2026.112151_bb0030","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1002\/gps.2454","article-title":"Effectiveness of melatonin treatment on circadian rhythm disturbances in dementia. Are there implications for delirium? A systematic review","volume":"25","author":"De Jonghe","year":"2010","journal-title":"Int J Geriatr Psychiatry"},{"key":"10.1016\/j.jclinane.2026.112151_bb0035","doi-asserted-by":"crossref","first-page":"4046","DOI":"10.1007\/s12035-015-9350-8","article-title":"Exogenous melatonin for delirium prevention: a meta-analysis of randomized controlled trials","volume":"53","author":"Chen","year":"2016","journal-title":"Mol Neurobiol"},{"key":"10.1016\/j.jclinane.2026.112151_bb0040","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2023.1255752","article-title":"The relationship between anesthesia and melatonin: a review","volume":"14","author":"Guo","year":"2023","journal-title":"Front Pharmacol"},{"key":"10.1016\/j.jclinane.2026.112151_bb0045","article-title":"Early postoperative cognitive decline\u2014are there any preventive strategies for surgical patients in the emergency setting?","year":"2024","journal-title":"Signa Vitae"},{"key":"10.1016\/j.jclinane.2026.112151_bb0050","article-title":"Melatonin as adjuvant treatment in COVID-19 patients. A meta-analysis of randomized and propensity matched studies","year":"2023","journal-title":"Signa Vitae"},{"key":"10.1016\/j.jclinane.2026.112151_bb0055","doi-asserted-by":"crossref","first-page":"E547","DOI":"10.1503\/cmaj.140495","article-title":"Effect of melatonin on incidence of delirium among patients with hip fracture: a multicentre, double-blind randomized controlled trial","volume":"186","author":"De Jonghe","year":"2014","journal-title":"Can Med Assoc J"},{"key":"10.1016\/j.jclinane.2026.112151_bb0060","series-title":"Cochrane handbook for systematic reviews of interventions","author":"Higgins","year":"2019"},{"key":"10.1016\/j.jclinane.2026.112151_bb0065","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ"},{"key":"10.1016\/j.jclinane.2026.112151_bb0070","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g7647","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation","volume":"349","author":"Shamseer","year":"2015","journal-title":"BMJ"},{"key":"10.1016\/j.jclinane.2026.112151_bb0075","doi-asserted-by":"crossref","first-page":"169","DOI":"10.4103\/1658-354X.71132","article-title":"Assessment of role of perioperative melatonin in prevention and treatment of postoperative delirium after hip arthroplasty under spinal anesthesia in the elderly","volume":"4","author":"Sultan","year":"2010","journal-title":"Saudi J Anaesth"},{"key":"10.1016\/j.jclinane.2026.112151_bb0080","doi-asserted-by":"crossref","DOI":"10.7860\/JCDR\/2019\/42635.13384","article-title":"The effect of ramelteon on postoperative delirium in elderly patients: a randomised double-blind study","author":"Gupta","year":"2019","journal-title":"J Clin Diagn Res"},{"key":"10.1016\/j.jclinane.2026.112151_bb0085","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1097\/CCM.0000000000004004","article-title":"Ramelteon for prevention of postoperative delirium: a randomized controlled trial in patients undergoing elective pulmonary thromboendarterectomy\u2217","volume":"47","author":"Jaiswal","year":"2019","journal-title":"Crit Care Med"},{"key":"10.1016\/j.jclinane.2026.112151_bb0090","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1080\/11101849.2021.1885956","article-title":"Postoperative delirium after coronary artery bypass graft surgery: dexmedetomidine infusion alone or with the addition of oral melatonin","volume":"37","author":"Mahrose","year":"2021","journal-title":"Egypt J Anaesth"},{"key":"10.1016\/j.jclinane.2026.112151_bb0095","doi-asserted-by":"crossref","first-page":"E893","DOI":"10.1532\/hsf.4049","article-title":"Effects of melatonin on postoperative delirium after PCI in elderly patients: a randomized, single-center, double-blind, placebo-controlled trial: anti-delirium effects of melatonin","volume":"24","author":"Shi","year":"2021","journal-title":"Heart Surg Forum"},{"key":"10.1016\/j.jclinane.2026.112151_bb0100","article-title":"Effect of melatonin on delirium after on-pump coronary artery bypass graft surgery: a randomized clinical trial","author":"Javaherforoosh Zadeh","year":"2020","journal-title":"Iran J Med Sci"},{"key":"10.1016\/j.jclinane.2026.112151_bb0105","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1016\/j.jagp.2023.07.011","article-title":"The efficacy of ramelteon to prevent postoperative delirium after general anesthesia in the elderly: a double-blind, randomized, placebo-controlled trial","volume":"31","author":"Kinouchi","year":"2023","journal-title":"Am J Geriatr Psychiatry"},{"key":"10.1016\/j.jclinane.2026.112151_bb0110","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jagp.2020.05.006","article-title":"Effects of ramelteon on the prevention of postoperative delirium in older patients undergoing orthopedic surgery: the RECOVER randomized controlled trial","volume":"29","author":"Oh","year":"2021","journal-title":"Am J Geriatr Psychiatry"},{"key":"10.1016\/j.jclinane.2026.112151_bb0115","doi-asserted-by":"crossref","first-page":"178","DOI":"10.5152\/TJAR.2022.20017","article-title":"Performance of melatonin as prophylaxis in geriatric patients with multifactorial risk for postoperative delirium development: a randomized comparative study","volume":"50","author":"Department of Anaesthesia, Cairo University Faculty of Medicine, Cairo, Egypt","year":"2022","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"10.1016\/j.jclinane.2026.112151_bb0120","doi-asserted-by":"crossref","DOI":"10.23736\/S0375-9393.24.17888-1","article-title":"The impact of melatonin on postoperative delirium in geriatric patients after colorectal surgery: a randomized placebo-controlled trial","volume":"90","author":"Elbakry","year":"2024","journal-title":"Minerva Anestesiol"},{"key":"10.1016\/j.jclinane.2026.112151_bb0125","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jclinane.2017.03.023","article-title":"The effect of melatonin on early postoperative cognitive decline in elderly patients undergoing hip arthroplasty: a randomized controlled trial","volume":"39","author":"Fan","year":"2017","journal-title":"J Clin Anesth"},{"key":"10.1016\/j.jclinane.2026.112151_bb0130","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.jclinane.2026.112151_bb0135","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"10.1016\/j.jclinane.2026.112151_bb0140","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jclinepi.2010.07.015","article-title":"GRADE guidelines: 3. Rating the quality of evidence","volume":"64","author":"Balshem","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.jclinane.2026.112151_bb0145","series-title":"A study of the prophylactic and curative effect of melatonin on postoperative delirium after coronary artery bypass grafting surgery in elderly patients","author":"Sharaf","year":"2018"},{"key":"10.1016\/j.jclinane.2026.112151_bb0150","series-title":"The effect of melatonin on prevention of postoperative delirium after lower limb fracture surgery in elderly patients: a randomized double blind clinical trial","author":"Fazel","year":"2022"},{"key":"10.1016\/j.jclinane.2026.112151_bb0155","article-title":"The efficacy of melatonin and clonidine in preventing emergence delirium in the elderly undergoing orthopedic surgery, neurosurgery, and general surgery: a placebo-controlled randomized clinical trial","volume":"26","author":"Esmaeili","year":"2022","journal-title":"J Kerman Univ Med Sci"},{"key":"10.1016\/j.jclinane.2026.112151_bb0160","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1111\/j.1755-5949.2008.00066.x","article-title":"Pharmacology of ramelteon, a selective MT1\/MT2 receptor agonist: a novel therapeutic drug for sleep disorders","volume":"15","author":"Miyamoto","year":"2009","journal-title":"CNS Neurosci Ther"},{"key":"10.1016\/j.jclinane.2026.112151_bb0165","doi-asserted-by":"crossref","DOI":"10.3390\/biom10091211","article-title":"Melatonin\u2019s impact on antioxidative and anti-inflammatory reprogramming in homeostasis and disease","volume":"10","author":"Chitimus","year":"2020","journal-title":"Biomolecules"},{"key":"10.1016\/j.jclinane.2026.112151_bb0170","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12020435","article-title":"Melatonin or ramelteon for delirium prevention in the intensive care unit: a systematic review and meta-analysis of randomized controlled trials","volume":"12","author":"Aiello","year":"2023","journal-title":"J Clin Med"},{"key":"10.1016\/j.jclinane.2026.112151_bb0175","doi-asserted-by":"crossref","first-page":"532","DOI":"10.3390\/antiox11030532","article-title":"Melatonin and related compounds: antioxidant and anti-inflammatory actions","volume":"11","author":"Bantounou","year":"2022","journal-title":"Antioxidants"},{"key":"10.1016\/j.jclinane.2026.112151_bb0180","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1100\/2012\/640389","article-title":"Neurobiology, pathophysiology, and treatment of melatonin deficiency and dysfunction","volume":"2012","author":"Hardeland","year":"2012","journal-title":"Sci World J"},{"key":"10.1016\/j.jclinane.2026.112151_bb0185","doi-asserted-by":"crossref","first-page":"44","DOI":"10.47936\/encephalitis.2022.00094","article-title":"Neuroprotective effects of melatonin in neurodegenerative and autoimmune central nervous system diseases","volume":"3","author":"Shin","year":"2023","journal-title":"Encephalitis"},{"key":"10.1016\/j.jclinane.2026.112151_bb0190","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/jpi.12360","article-title":"Melatonin as an antioxidant: under promises but over delivers","volume":"61","author":"Reiter","year":"2016","journal-title":"J Pineal Res"},{"key":"10.1016\/j.jclinane.2026.112151_bb0195","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1016\/j.clinthera.2006.10.016","article-title":"Ramelteon for the treatment of insomnia","volume":"28","author":"Borja","year":"2006","journal-title":"Clin Ther"},{"key":"10.1016\/j.jclinane.2026.112151_bb0200","doi-asserted-by":"crossref","DOI":"10.1111\/jpi.12801","article-title":"High dose melatonin increases sleep duration during nighttime and daytime sleep episodes in older adults","volume":"73","author":"Duffy","year":"2022","journal-title":"J Pineal Res"}],"container-title":["Journal of Clinical Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0952818026000292?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0952818026000292?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T14:36:28Z","timestamp":1777041388000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0952818026000292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":40,"alternative-id":["S0952818026000292"],"URL":"https:\/\/doi.org\/10.1016\/j.jclinane.2026.112151","relation":{},"ISSN":["0952-8180"],"issn-type":[{"value":"0952-8180","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Melatonin or ramelteon for the prevention of postoperative delirium in elderly patients: A systematic review and meta-analysis of randomized clinical trials","name":"articletitle","label":"Article Title"},{"value":"Journal of Clinical Anesthesia","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jclinane.2026.112151","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"112151"}}