The Influence of Melatonin on Sleep Quality After Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials

Introduction: The efficacy of melatonin to improve sleep quality after laparoscopic cholecystectomy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of melatonin intervention versus placebo on sleep quality after laparoscopic cholecystectomy. Methods: We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane library databases through July 2018 for randomized controlled trials assessing the effect of melatonin intervention versus placebo on sleep quality after laparoscopic cholecystectomy. This meta-analysis is performed using the random-effect model. Results: Five randomized controlled trials involving 250 patients are included in the meta-analysis. Overall, compared with control group for laparoscopic cholecystectomy, melatonin intervention shows no substantial impact on well-being [standard mean difference (std MD)=0.05; 95% confidence interval (CI)=-0.26 to 0.36; P=0.76], sleepiness (std MD=-0.10; 95% CI=-0.44 to 0.23; P=0.54), sleep quality (std MD=0.10; 95% CI=-0.21 to 0.41; P=0.53), pain scores after 1 hour (std MD=-0.26; 95% CI=-1.08 to 0.56; P=0.53) and 3 hours (std MD=-0.86; 95% CI=-2.69 to 0.97; P=0.36), headache [risk ratio (RR)=1.25; 95% CI=0.42-3.71; P=0.68], depression (RR=1.03; 95% CI=0.15-7.21; P=0.97), dizziness (RR=1.09; 95% CI=0.14-9.40; P=0.94). Conclusions: Melatonin intervention has no significant influence on well-being, sleepiness, sleep quality, pain intensity after 1 and 3 hours, headache, depression, and dizziness for laparoscopic cholecystectomy.