Evidence map›Paper›PMID 40026724›Full record

ReviewJournal of anaesthesiology, clinical pharmacology

Perioperative approaches to prevent delayed neurocognitive recovery and postoperative neurocognitive disorder in older surgical patients: A systematic review and meta-analysis of randomized controlled trials.

Yasmin Alhamdah, Wei-Ya Li, Mahesh Nagappa, Ellene Yan, David He, Aparna Sarieplla, Marina Englesakis, Zeyad Elias, Matthew T V Chan, Dong-Xin Wang and 1 more

3 registry-linked trialsAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of anaesthesiology, clinical pharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT07576517 phase4not yet recruitingnot on this map

Perioperative Use of Dexmedetomidine-esketamine Combination and Transcranial Direct Current Stimulation for Prevention of Neurocognitive Complications in Older Patients After Non-cardiac Surgery: a 2×2 Factorial Trial

TypeinterventionalSponsorPeking University First HospitalRan2026 to 2030Enrolled1,160ConditionsOlder Patients, Surgery, Dexmedetomidine, EsketamineArmsDex-Esk, Placebo, Active tDCS, Sham tDCS
NCT07576543 phase4not yet recruitingnot on this map

Long-term Follow-up of Perioperative Dexmedetomidine-esketamine Combination and Transcranial Direct Current Stimulation for Prevention of Neurocognitive Complications in Older Patients After Non-cardiac Surgery

TypeinterventionalSponsorPeking University First HospitalRan2026 to 2031Enrolled1,160ConditionsOlder Patients, Surgery, Dexmedetomidine, EsketamineArmsDex-Esk, Placebo, Active tDCS, Sham tDCS
NCT07736092 narecruitingnot on this map

Impact of Perioperative Transcranial Photobiomodulation on Delayed Neurocognitive Recovery in Older Patients After Surgery: a Randomized, Double-blind, Pseudo-modulation-controlled Preliminary Clinical Trial

TypeinterventionalSponsorPeking University First HospitalRan2026 to 2027Enrolled130ConditionsOlder Adults, Surgery, Transcranial Photobiomodulation, Delayed Neurocognitive RecoveryArmsTranscranial photobiomodulation therapy, Transcranial pseudo-photobiomodulation
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yasmin Alhamdah *Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Wei-Ya Li *Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Mahesh NagappaDepartment of Anesthesia and Perioperative Medicine, London Health Science Centre and St. Joseph's Healthcare, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Ellene YanDepartment of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
David HeDepartment of Anesthesiology and Pain Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
Aparna SariepllaDepartment of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Marina EnglesakisLibrary and Information Services, University Health Network, Toronto, ON, Canada.
Zeyad EliasTemerty Faculty of Medicine, University of Toronto, ON, Canada.
Matthew T V ChanDepartment of Anesthesiology, Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Dong-Xin WangDepartment of Anesthesiology, Peking University First Hospital, Beijing, China.
Frances ChungDepartment of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: Delayed neurocognitive recovery (DNR) and postoperative neurocognitive disorder (P-NCD) are common postoperative complications affecting older patients. This review evaluates perioperative approaches for preventing DNR and P-NCD in older noncardiac surgical patients. Material and Methods: We searched databases for relevant articles from inception through June 2022 and updated in May 2023 (PROSPERO ID CRD42022359289). Randomized controlled trials (RCTs) utilizing intervention for DNR and/or P-NCD were included. Results: We included 39 RCTs involving anesthetic (25 RCTs, 7422 patients) and other pharmacological and nonpharmacological approaches (14 RCTs, 2210 patients). Seventeen trials investigating four interventions were included in the meta-analysis for DNR. Perioperative dexmedetomidine (relative risk [RR]: 0.59, 95% confidence interval [CI]: 0.35-0.97; Conclusions: Our meta-analysis of RCTs showed that dexmedetomidine and TIVA decrease the risk of DNR in older patients undergoing noncardiac surgery by 41% and 20%, respectively, versus control. Further RCTs of adequate power and methodology on the effects of interventions on DNR and P-NCD are warranted.

Indexed as

Anesthesiadelayed neurocognitive recoveryolder patientsOur meta-analysis of RCTs showed that dexmedetomidine and TIVA decrease the risk of DNR in older patients undergoing noncardiac surgery by 41% and 20%, respectively, versus controls, whereas RA and BIS monitoring do not.postoperative neurocognitive disordersurgery

Identifiers

PMID40026724
PMCPMC11867347

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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 OpenQuestion graph.