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Table 5 Summary of the efficacy of the interventions.

From: Strategies for prevention of postoperative delirium: a systematic review and meta-analysis of randomized trials

Conclusions based on

Perioperative procedures and drugs (>, superior to; =, equally effective to; UC*, uncertain)

Pharmacological, psychological or multicomponent interventions (>, superior to; =, equally effective to; UC, uncertain)

Meta-analysis

Postoperative sedation: dexmedetomidine > other sedatives [41, 44]

Typical antipsychotics > placebo [22, 29, 54]

Atypical antipsychotics > placebo [36, 45, 52]

Multicomponent interventions > standard [25, 35]

 

Anesthesia type: neuraxial = general [17, 20, 27, 31]

Analgesia type: epidural = intravenous [19, 24, 32]

Acetylcholinesterase inhibitors = placebo [30, 37, 39, 48]

  

Atypical antipsychotics UC typical antipsychotics [22, 29, 36, 45, 52, 54]

Sleep restoration: bright light UC standard [38, 49]

Single study

Sedation depth: light > deep [47]

Additional ketamine > routine general anesthesia induction [40]

Additional fascia iliaca compartment block > standard analgesia [43]

Anticonvulsants: gabapentin > placebo [33]; pregabalin > placebo [50]

Sleep restoration: diazepam/flunitrazepam/pethidine > standard [26]

 

Additional N2O during general anesthesia = standard [34]

Histamine H2 blockers: cimetidine UC ranitidine [21]

Psychiatric intervention UC standard [18]

Music UC standard [42]

 

Controlled hypotension: mild UC marked [23]

Anesthetics plus epidural anesthesia: propofol UC sevoflurane [28]

Anesthetics during general anesthesia: propofol UC desflurane [51]

Analgesics: Long-acting morphine UC placebo [53]

Postoperative sedation: clonidine UC other sedatives [46]

 
  1. *The efficacy is considered uncertain if there is more than 50% difference in incidences of delirium between the two interventions, or if the quality score of the trial is below 6.
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Critical Care

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