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The efficacy of peri‐operative interventions to decrease postoperative delirium in non‐cardiac surgery: a systematic review and meta‐analysis.
Author(s) -
Moyce Z.,
Rodseth R. N.,
Biccard B. M.
Publication year - 2014
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.12539
Subject(s) - medicine , delirium , meta analysis , incidence (geometry) , psychological intervention , perioperative , randomized controlled trial , general anaesthesia , anesthesia , haloperidol , emergence delirium , systematic review , medline , surgery , intensive care medicine , nursing , physics , political science , law , optics , dopamine
Summary The purpose of this meta‐analysis was to determine the efficacy of peri‐operative interventions in decreasing the incidence of postoperative delirium. An electronic search of four databases was conducted. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were adhered to. We included randomised controlled trials of non‐cardiac surgery with a peri‐operative intervention and that reported postoperative delirium, and identified 29 trials. Meta‐analysis revealed that peri‐operative geriatric consultation ( OR 0.46, 95% CI 0.32–0.67) and lighter anaesthesia ( OR 2.66, 95% CI 1.27–5.56) were associated with a decreased incidence of postoperative delirium. For the other interventions, the point estimate suggested possible protection with prophylactic haloperidol ( OR 0.62, 95% CI 0.36–1.05), bright light therapy ( OR 0.20, 95% CI 0.03–1.19) and general as opposed to regional anaesthesia ( OR 0.76, 95% CI 0.47–1.23). This meta‐analysis has shown that peri‐operative geriatric consultations with multicomponent interventions and lighter anaesthesia are potentially effective in decreasing the incidence of postoperative delirium.