Table 1.
Summary of the baseline characteristics of included trials.
Study | Country | Dosing Information | Control | Begin Time | Following Time | Type of Surgery | Age (years) |
Male (%) |
Incidence (%) |
N |
---|---|---|---|---|---|---|---|---|---|---|
Avidan 2017 [16] |
USA | 0.5 or 1.0 mg/kg ketamine by injection as single dose. | placebo | before surgery | 3d | major surgery | 70 | 62.2 | 19.6 | 672 |
| ||||||||||
Clemmesen 2017 [17] |
Denmark | 125 mg methylprednisolone by injection for once. | saline | before surgery | 3d | hip | 80 | 35.9 | 24.8 | 117 |
| ||||||||||
de Jonghe 2014 [18] |
Netherlands | 3 mg melatonin taken orally for 5 days. | placebo | before surgery | 8d | hip | 84 | 29.9 | 27.5 | 378 |
| ||||||||||
Deiner 2017 [19] |
USA | 0.5 μg/kg/h dexme by infusion continued until 2 hours into recovery. | saline | before surgery | 30d | cardiac | 74 | 48.7 | 15.4 | 390 |
| ||||||||||
Dieleman 2012 [20] |
Netherlands | 1 mg/kg dexamethasone by injection for once. | placebo | during surgery | 30d | cardiac | 66 | 72.5 | 10.4 | 4482 |
| ||||||||||
Dighe 2014 [21] |
Canada | 200 mg gabapentin taken orally tid for 4 days. | placebo | after surgery | NA | knee | 63 | 49.7 | 10.6 | 161 |
| ||||||||||
Djaiani 2016 [22] |
Canada | a bolus of 0.4 μg/kg dexme followed by 0.2-0.7 μg/kg/h infusion for maximum 24 h. | propofol | after surgery | 5d | cardiac | 73 | 75.4 | 24.6 | 183 |
| ||||||||||
Farlinger 2018 [23] |
Canada | 150 mg pregabalin preoperatively and 75 mg bid postoperatively for 7 days. | placebo | before surgery | NA | hip | 60 | 50.9 | 0.6 | 163 |
| ||||||||||
Fukata 2014 [24] |
Japan | 2.5 mg haloperidol for 3 days. | blank | after surgery | 7d | abdominal, orthopedic | 80 | 52.9 | 37.2 | 121 |
| ||||||||||
Gamberini 2009 [25] |
Switzerland | 1.5 mg oral rivastigmine tid for 7 days. | placebo | before surgery | 6d | cardiac | 74 | 68.1 | 31 | 113 |
| ||||||||||
Hudetz 2009 [26] |
USA | 0.5 mg/kg ketamine intravenous bolus for once. | saline | before surgery | 5d | cardiac | 64 | NA | 17.2 | 58 |
| ||||||||||
Kalisvaart 2005 [27] |
Netherlands | 0.5 mg haloperidol tid until 3 days after surgery | saline | before surgery | 14d | hip | 79 | 20.2 | 15.8 | 430 |
| ||||||||||
Kaneko 1999 [28] |
Japan | 5 mg haloperidol intravenous for 5 days | saline | after surgery | 5d | gastrointestinal | 73 | 64.1 | 21.8 | 78 |
| ||||||||||
Larsen 2010 [29] |
USA | 5 mg of orally-disintegrating olanzapine or placebo just before and after surgery. | placebo | before surgery | 8d | joint | 74 | 45.8 | 27.5 | 400 |
| ||||||||||
Lee 2018 [30] |
Korea | 1 μg/kg bolus dexme followed by 0.2-0.7 μg/kg/h infusion during surgery. | saline | before surgery | 5d | laparoscopic | 73 | 44.3 | 17.9 | 318 |
| ||||||||||
Leung 2017 [31] |
USA | 900 mg gabapentin administered preoperatively and for the first 3 postoperative days. | placebo | before surgery | 3d | orthopedic | 73 | 49.6 | 22.4 | 697 |
| ||||||||||
Li.X 2017 [32] |
China | 0.6 μg/kg dexme for 10 minutes followed by 0.4 μg/kg/h during surgery. | placebo | before surgery | 5d | cardiac | 67 | 68.6 | 6.3 | 287 |
| ||||||||||
Li.YN 2017 [33] |
China | 7.5 μg/kg/h nimodipine was injected continually 30minutes before anesthesia induction. | saline | before surgery | 7d | spine | 70 | 40 | 11.7 | 60 |
| ||||||||||
Liu. YZ 2016 [34] |
China | 0.2-0.4 μg/kg/h dexme during surgery | saline | before surgery | 7d | joint | 73 | 48.7 | 29.4 | 197 |
| ||||||||||
Maldonado 2009 [35] |
USA | received one of three postoperative sedation regimens: dexme, propofol and midazolam. | propofol, midazolam | after surgery | 3d | cardiac | 58 | 63.8 | 34.4 | 90 |
| ||||||||||
Mardani 2013 [36] |
Iran | 8 mg of intravenous dexamethasone before surgery and followed by 8 mg q8h for 3 days. | placebo | before surgery | 3d | cardiac | 62 | NA | 18.3 | 93 |
| ||||||||||
Mei 2018 [37] |
China | a bolus of dexme at 0.8-1.0 μg/kg followed by 0.1-0.5 μg/kg/h infusion or propofol. | propofol | before surgery | 7d | hip | 75 | 45.6 | 11.8 | 296 |
| ||||||||||
Mohammadi 2016 [38] |
Iran | 4 mg cyproheptadine tid for 7 days. | placebo | after surgery | 7d | non-cardiac | 60 | 65 | 25 | 40 |
| ||||||||||
Papadopoulos 2014 [39] |
Greece | 8 mg intravenous ondansetron daily for 5 days. | placebo | after surgery | 5d | femoral, hip | 72 | 44.3 | 44.3 | 106 |
| ||||||||||
Park 2014 [40] |
Korea | loading dose of 0.5 μg/kg dexme followed by 0.2-0.8 μg/kg/h or remifentanil 1-2.5 mg/h during ICU. | remifentanil | after surgery | 3d | cardiac | 53 | 55.6 | 16.2 | 142 |
| ||||||||||
Prakanrattana 2007 [41] |
Thailand | 1 mg risperidone sublingually when regained consciousness | placebo | after surgery | 3d | cardiac | 61 | 58.7 | 21.4 | 126 |
| ||||||||||
Priye 2015 [42] |
India | 0.4 μg/kg/h dexme for 12 hours. | saline | after surgery | ICU | cardiac | 43 | 51.6 | 9.4 | 64 |
| ||||||||||
Robinson 2014 [43] |
USA | 1g tryptophan enterally tid for 3 days. | placebo | after surgery | ICU | mixed | 69 | 98 | 38.5 | 301 |
| ||||||||||
Royse 2017 [44] |
Australia | 250 mg methylprednisolone at induction and 250 mg methylprednisolone before surgery. | placebo | during surgery | 3d | cardiac | 74 | 64.1 | 9.2 | 298 |
| ||||||||||
Sampson 2007 [45] |
UK | 5 mg donepezil after surgery and continuing for a further 3 days. | placebo | after surgery | 4d | hip | 69 | 51.5 | 21.2 | 33 |
| ||||||||||
Shehabi 2009 [46] |
Australia | received dexme 0.1–0.7g/kg/h or morphine 10-70g/kg/h to maintain target sedation & analgesia. | morphine | after surgery | 5d | cardiac | 71 | 75.3 | 11.7 | 299 |
| ||||||||||
Sheikh 2018 [47] |
India | 1 μg/kg dexme bolus followed by infusion 0.2–0.6 μg/kg/h or 0.25–1 mg/kg/h propofol | propofol | before surgery | ICU | cardiac | 35 | NA | 13.3 | 60 |
| ||||||||||
Su 2016 [48] |
China | dexme 0.1 μg/kg/h from ICU admission on the day of surgery until 08:00 h on postoperative day 1. | saline | after surgery | 7d | non-cardiac | 74 | 60.4 | 15.9 | 700 |
| ||||||||||
Sugano 2017 [49] |
Japan | 2.5g TJ-54 tid for 7 days prior to surgery and 4 days after surgery, except for the operation day. | blank | before surgery | NA | gastrointestinal, lung | 77 | 64.5 | 8.1 | 186 |
| ||||||||||
Wang 2012 [50] |
China | 0.5 mg haloperidol intravenous bolus followed by infusion at a rate of 0.1 mg/h for 12 hours. | saline | after surgery | 7d | non-cardiac | 74 | 41.1 | 19.3 | 457 |
| ||||||||||
Whitlock 2015 [51] |
Canada | 250 mg methylprednisolone at anaesthetic induction and 250 mg at initiation of cardiopulmonary bypass. | placebo | during surgery | 3d | cardiac | 67 | 60.4 | 7.8 | 7507 |
| ||||||||||
Xin 2017 [52] |
China | 4ml/kg 7.5% hypertonic saline was given before surgery. | saline | before surgery | 3d | hip | 76 | 51.7 | 25 | 120 |
| ||||||||||
Yang 2015 [53] |
China | 0.5 mg/kg dexme was given for 1 hour. | saline | before surgery | 5d | free flap | 50 | 53.2 | 8.9 | 79 |
Note: dexme: dexmedetomidine; N: the number of participants; NA: not available.