ArticleInternational journal of surgery (London, England)2026
Comparative efficacy of non-pharmacological interventions on emergency delirium in postoperative children: a systematic review and Bayesian network meta-analysis.
Article in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- The Effect of Preoperative Visual Explanation on Anxiety in Children: A Randomized Controlled Trial.Journal of clinical medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergence delirium (ED) is a distressing complication in pediatric patients following general anesthesia, often resulting in self-injury, extended hospitalization, and emotional distress for families. Although non-pharmacological interventions are being increasingly utilized, their effectiveness remains uncertain.
methodsWe conducted a systematic review and Bayesian network meta-analysis. PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases were searched from inception to 17 November 2024, with an updated search performed on 24 July 2025. Randomized controlled trials (RCTs) evaluating non-pharmacological interventions in children (<18 years) undergoing general anesthesia were included. Studies involving pharmacological co-interventions were excluded. Two reviewers independently extracted data and assessed the risk of bias using the Cochrane Risk of Bias 2.0 (RoB 2.0) tool. Bayesian random-effects models were applied, and effectiveness of interventions was ranked using surface under the cumulative ranking curve (SUCRA) values.
resultsA total of 56 RCTs involving 6183 pediatric participants were included. Among 37 non-pharmacological strategies, virtual reality (VR) and ice popsicles were the most effective in reducing ED [VR: risk ratios (RR) = 0.082, 95% credible interval (CrI) 0.010-0.311; ice popsicle: RR = 0.157, 95% CrI 0.057-0.388]. VR also ranked highest for postoperative pain reduction (standardized mean difference = -2.68, 95% CrI -3.47 to -1.88). For anxiety outcomes, parental active participation in anesthesia induction (PAPIA) was most effective in reducing children's perioperative anxiety (SUCRA = 86.1%), while parental educational programs (EP) ranked highest for reducing caregiver anxiety (SUCRA = 78.3%). No intervention significantly improved compliance on the Induction Compliance Checklist.
conclusionsThis Bayesian network meta-analysis provides low-to-moderate certainty evidence suggesting that VR and simple oral cold stimulation (ice popsicles) may reduce ED and early postoperative pain in children. PAPIA may modestly reduce children's perioperative anxiety, while EP appears most effective in alleviating parental anxiety. However, no intervention demonstrated significant improvement in induction compliance.
Indexed as
Identifiers
What OpenQuestion holds
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.