Infants admitted to neonatal intensive care units are repeatedly stimulated by painful events, especially if intubated. Preterm infants are known to have greater pain perception than full term infants due to immaturity of descending inhibitory circuits and poor noxious inhibitory modulation. Newborns exposed to repetitive painful stimuli are at high risk of impairments in brain development and cognition. Chronic pain is induced and supported by proinflammatory cytokines, free radicals, and reactive oxygen species creating a self- sustaining vicious circle. Melatonin is a neurohormone secreted by the pineal gland with antioxidant and anti-inflammatory functions. This review describes the in-depth beneficial effects of melatonin for pain control in ventilated preterm newborns. As yet, a minimal amount of literature has been undertaken to consider all its promising bioactivities. The rationale behind the use of melatonin for pain control has also been taken into account in this review. Besides, this review addresses safety concerns and dosages. The potential benefits of melatonin have been assessed against neurological disorders, respiratory distress, microbial infections, and as analgesic adjuvant during ventilation. Additionally, a possible approach for the use of melatonin in ventilated newborns will be discussed.

中文翻译：

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褪黑激素控制通气早产儿疼痛的潜在益处：最新综述


入住新生儿重症监护病房的婴儿会反复受到疼痛事件的刺激，尤其是插管时。已知早产儿比足月儿有更大的疼痛感知，这是由于下行抑制回路的不成熟和不良的有害抑制调节。暴露于重复性疼痛刺激的新生儿大脑发育和认知受损的风险很高。慢性疼痛由促炎细胞因子、自由基和活性氧诱导和支持，形成自我维持的恶性循环。褪黑激素是松果体分泌的一种神经激素，具有抗氧化和抗炎功能。这篇综述描述了褪黑激素对通气早产儿疼痛控制的深入有益作用。迄今为止，已经进行了少量文献来考虑其所有有前景的生物活性。本次综述还考虑了使用褪黑激素控制疼痛的基本原理。此外，本次审查还解决了安全问题和剂量。褪黑激素的潜在益处已针对神经系统疾病、呼吸窘迫、微生物感染以及作为通气期间的镇痛辅助剂进行了评估。此外，还将讨论在通气新生儿中使用褪黑激素的可能方法。