ArticleAnesthesia and pain medicine2021
Pharmacological strategies to prevent postoperative delirium: a systematic review and network meta-analysis.
Article in Anesthesia and pain medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- A comprehensive review and meta-analysis on the safety and efficacy of esketamine for emerging delirium in elderly patients.Frontiers in medicine · 2026Pooled it
- Perioperative dexmedetomidine for the prevention of postoperative delirium after cardiac surgery: a systematic review, Bayesian meta-analysis, and Bayesian re-analysis of the DECADE trial.British journal of anaesthesia · 2025Pooled it
- A pre-anesthetic bolus of ketamine versus dexmedetomidine for prevention of postoperative delirium in elderly patients undergoing emergency surgery: a randomized, double-blinded, placebo-controlled study.BMC anesthesiology · 2023Trial
- A systematic review and meta-analysis on ketamine use and postoperative delirium in older patients undergoing spine or orthopedic surgery.Anesthesiology and perioperative science · 2026Review
- Comparison of midazolam and dexmedetomidine on postoperative delirium in older patients undergoing total knee replacement under spinal anesthesia.Perioperative medicine (London, England) · 2025Article
- The Impact of Intraoperative Dexmedetomidine Infusion on Postoperative Delirium Prevention in Intensive Care Unit Patients after Esophagectomy: A Randomized Double-Blind Clinical Trial.Medical journal of the Islamic Republic of Iran · 2025Article
- Prevalence of Delirium After Abdominal Surgery and Association With Ketamine: A Retrospective, Propensity-Matched Cohort Study.Critical care explorations · 2024Article
- Learning in the Single-Cell OrganismInternational journal of molecular sciences · 2023Article
- Postoperative delirium in geriatric patients with hip fractures.Frontiers in aging neuroscience · 2022Review
- Evidence-Based Guideline on Management of Postoperative Delirium in Older People for Low Resource Setting: Systematic Review Article.International journal of general medicine · 2022Review
- Trial sequential analysis: novel approach for meta-analysis.Anesthesia and pain medicine · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPostoperative delirium (POD) is a condition of cerebral dysfunction and a common complication after surgery. This study aimed to compare and determine the relative efficacy of pharmacological interventions for preventing POD using a network meta-analysis.
methodsWe performed a systematic and comprehensive search to identify and analyze all randomized controlled trials until June 29, 2020, comparing two or more pharmacological interventions, including placebo, to prevent or reduce POD. The primary outcome was the incidence of POD. We performed a network meta-analysis and used the surface under the cumulative ranking curve (SUCRA) values and rankograms to present the hierarchy of the pharmacological interventions evaluated.
resultsAccording to the SUCRA value, the incidence of POD decreased in the following order: the combination of propofol and acetaminophen (86.1%), combination of ketamine and dexmedetomidine (86.0%), combination of diazepam, flunitrazepam, and pethidine (84.8%), and olanzapine (75.6%) after all types of anesthesia; combination of propofol and acetaminophen (85.9%), combination of ketamine and dexmedetomidine (83.2%), gabapentin (82.2%), and combination of diazepam, flunitrazepam, and pethidine (79.7%) after general anesthesia; and ketamine (87.1%), combination of propofol and acetaminophen (86.0%), and combination of dexmedetomidine and acetaminophen (66.3%) after cardiac surgery. However, only the dexmedetomidine group showed a lower incidence of POD than the control group after all types of anesthesia and after general anesthesia.
conclusionsDexmedetomidine reduced POD compared with the control group. The combination of propofol and acetaminophen and the combination of ketamine and dexmedetomidine seemed to be effective in preventing POD. However, further studies are needed to determine the optimal pharmacological intervention to prevent POD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.