| Li et al., 2022[@192874] |
Open-label RCT |
9 university Teaching Hospitals in SE China |
950 patients, aged 65 years or older with fragility hip fracture requiring surgical repair. |
Regional vs general anesthesia |
Postoperative delirium incidence |
Unadjusted relative risk [RR], 1.2 [95%CI, 0.7 to 2.0] |
Large study with validated assessment tool
Low incidence of delirium, most patients enrolled from single centre |
In this population, regional anaesthesia did not reduce the incidence of postoperative delirium compared with general anesthesia |
Neuman et al.,
2021[@192879] |
Pragmatic RCT |
46 U.S. and Canadian Hospitals |
1600 patients, aged 50 years or older |
Spinal vs general anesthesia |
Secondary outcome of delirium incidence in 60 days after surgery |
Unadjusted relative risk [RR], 1.04 [95%CI, 0.84 to 1.30] |
Large study with validated assessment tool
Considerable amount of missing data, 15% group crossover |
In this population, spinal anaesthesia did not reduce the incidence of postoperative delirium compared with general anesthesia |
| Wibrow et al., 2022[@192879] |
Double blinded, Placebo- controlled RCT |
12 Australian Hospitals |
847 patients, 18 years or older with expected ICU LOS >72 hours, enrolled within 48hrs of ICU admission |
4mg enteral melatonin daily vs placebo |
Proportion of Delirium-free assessments |
64.9% (intervention) vs 67.6% (control) delirium free days, p=0.466 |
Largest melatonin for delirium prevention trial to date
Only in ICU, dose may have been insufficient, rate of delirium lower than anticipated |
Enteral melatonin did not reduce the prevalence of delirium compared to placebo |