ReviewArthroplasty (London, England)2025
The association between peripheral nerve blocks and postoperative delirium in adults undergoing hip fracture surgery: a systematic review and meta-analysis.
Review in Arthroplasty (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
4 authors.
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Abstract
objectiveTo review and synthesise the existing evidence on the effects of peripheral nerve block (PNB) compared with no nerve block on the incidence of postoperative delirium (POD) in adults undergoing hip fracture repair.
methodsA systematic search of electronic databases (PubMed, Web of Science, EMBASE, and the Cochrane Library) for relevant literature published from database inception to 1st May 2025 was conducted. Randomised controlled trials with PNBs as an intervention in adults undergoing surgery for hip fractures were selected. Studies that excluded patients with preoperative cognitive dysfunction and observed POD as an outcome were eligible.
resultsTwelve randomised controlled trials, involving a total of 1157 participants, 602 in the control group and 555 in the intervention, were included for quantitative analysis. The meta-analysis revealed that PNBs significantly reduced the incidence of POD (RR: 0.68, 95% CI [0.50 to 0.91], P = 0.009, I
conclusionIn patients without pre-existing cognitive impairment, the perioperative use of PNBs can reduce the occurrence of POD. However, substantial variation in study design and heterogeneity of PNB approaches limit the certainty of these findings. Future research calls for well-designed, standardised, and stratified clinical trials to compare the efficacy of each PNB approach and to evaluate their potential benefits in those at greater risk of POD, including those with baseline cognitive impairment and preoperative delirium. Video Abstract.
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