Nonpharmacological Interventions to Prevent Postoperative Delirium and Agitation Among Children: A Systematic Review.

PURPOSE: To systematically review nonpharmacological interventions to prevent postoperative delirium and agitation among children.

DESIGN

A systematic review.

METHODS

Our systematic review used specific criteria to identify randomized controlled trials and quasi-experimental research focused on postoperative delirium and agitation among children. From the period 2000 to January 25, 2025, six databases, namely Web of Science, Scopus, PubMed, EMBASE, Cochrane, and Google Scholar, were searched through search strategy and the use of Boolean operators.

FINDINGS: We screened 1,300 titles and abstracts, which resulted in the review of 21 full texts, and inclusion of 10 studies in the final analysis. Several nonpharmacological interventions, such as lollipop sucking, maternal voice recordings, eye-covering techniques, and bispectral index-guided anesthesia, significantly reduce postoperative delirium in children. However, methods like tablet use and virtual reality exposure have not shown significant benefits (P > .05). More research is necessary to confirm whether acupuncture electrical stimulation of the heart 7 acupuncture point can effectively prevent emergence delirium in children.

CONCLUSIONS

Based on these findings, nonpharmacological interventions like lollipop sucking, maternal voice, bispectral index-guided anesthesia, and eye covering may effectively reduce postoperative delirium in children, while others like tablets and virtual reality need further study. More research is necessary to confirm whether acupuncture and other interventions can effectively prevent emergence delirium in children.