The efficacy of peri-operative interventions to decrease postoperative delirium in non-cardiac surgery: A systematic review and meta-analysis

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Abstract

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. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

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Moyce, Z., Rodseth, R. N., & Biccard, B. M. (2014, March). The efficacy of peri-operative interventions to decrease postoperative delirium in non-cardiac surgery: A systematic review and meta-analysis. Anaesthesia. https://doi.org/10.1111/anae.12539

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