Evidence map›Paper›PMID 41146177›Full record

ArticleTrials2025

Positive suggestions via headphones during general anesthesia for the improvement of vegetative & cognitive postoperative course parameters in elderly orthopedic patients - a randomized controlled double-blinded trial (POSSUDEL).

Lena Heiß, Saskia Neitzert, Ernil Hansen, Hartmuth Nowak, Renate Neitzert, Thomas Saller

Abstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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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

6 authors.

Lena Heiß *Department of Anaesthesiology, LMU Hospital, Munich, Germany. l.heiss@med.uni-muenchen.de.ORCID http://orcid.org/0009-0003-6200-1164
Saskia Neitzert *Department of Anaesthesiology, LMU Hospital, Munich, Germany.
Ernil HansenDepartment of Anaesthesiology, UKR Hospital, Regensburg, Germany.
Hartmuth NowakDepartment of Anesthesiology, Intensive Care Medicine and Pain Therapy, Center for Artificial Intelligence, Medical Informatics and Data Science, Ruhr University Bochum, Knappschaft Kliniken University Hospital Bochum, Bochum, Germany.
Renate NeitzertDepartment of Anaesthesiology, LMU Hospital, Munich, Germany.
Thomas SallerDepartment of Anaesthesiology, LMU Hospital, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative delirium and cognitive deficits are significant surgical complications, especially in elderly patients. The reported incidence of postoperative delirium is variable but notably high in cardiothoracic, orthopedic, and general surgery. The etiology of postoperative delirium is known to be multifactorial, with prevention being the most effective strategy currently available. This study aims to explore the potential benefits of positive suggestions delivered via headphones during general anesthesia on the incidence of postoperative delirium and improving postoperative pain, nausea, and cognitive outcomes in elderly orthopedic patients.

methodsThis randomized controlled double-blinded trial will involve patients aged 60 and above undergoing elective hip or knee surgery under general anesthesia. Participants will be randomized into three groups: a control group receiving no auditory intervention and two intervention groups receiving positive therapeutic suggestions via headphones from either a male or female speaker. The primary outcome is the incidence of postoperative delirium within 5 days after surgery that will be assessed by using the 4AT and 3DCAM. Secondary outcomes include pain intensity, which is measured intraoperative by nociception level index (NOL) and postoperative by NRS, medication consumption as well as postoperative nausea and vomiting. Data will be collected before, during, and after surgery as well as 3 months after surgery. DISCUSSION: This study hypothesizes that positive auditory suggestions can reduce postoperative delirium incidence, lower pain intensity as well as pain medication use, and decrease postoperative nausea, vomiting incidence, and severity. Additionally, gender differences in response to male versus female voices will be explored. The findings could offer a non-invasive, cost-effective method to enhance postoperative recovery in elderly patients, potentially leading to changes in perioperative care practices.

trial registrationDRKS00030589 prospectively registered 25.10.2022.

Indexed as

Acoustic StimulationAnesthesia, GeneralCognitionDeliriumEmergence DeliriumOrthopedic ProceduresPostoperative Cognitive ComplicationsAgedAge FactorsArthroplasty, Replacement, KneeDouble-Blind MethodFemaleHumansIncidenceMaleMiddle AgedAnesthesiaDeliriumElderlyHeadphonesNociception level indexPainPONVPositive suggestionsProcessed EEGTotal intravenous anesthesia

Identifiers

PMID41146177
PMCPMC12560422

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Registered trials

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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.