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Meta-Analysis
. 2024 Feb 3;24(1):49.
doi: 10.1186/s12871-024-02434-8.

The effect of haloperidol's perioperative application on postoperative delirium in elderly patients: a systematic review and meta-analysis

Meinv Liu #  1 , Jie Su #  1 , Bei Wang  2 , Dongdong Yu  1 , Jianli Li  3 , Xinyu Cao  1   4
Affiliations
Meta-Analysis

The effect of haloperidol's perioperative application on postoperative delirium in elderly patients: a systematic review and meta-analysis

Meinv Liu et al. BMC Anesthesiol. .

Abstract

Objectives: To systematically review the evidence about the effect of haloperidol on postoperative delirium in elderly patients.

Methods: PubMed, Embase, the Cochrane Library and China National Knowledge Infrastructure were used to find concerned studies for meta-analysis. The main outcome was the incidence of postoperative delirium, and the secondary outcomes were side effects of haloperidol and the length of hospital stay. The meta-analyses were conducted using the Review Manager Version 5.1. This study was conducted based on the PRISMA statement.

Results: Eight RCTs (1569 patients) were included in the meta-analysis. There was a significant difference in the incidence of postoperative delirium between haloperidol and control groups (OR = 0.62, 95%CI 0.48-0.80, P = 0.0002, I2 = 20%). In addition, side effects of haloperidol and the duration of hospitalization were comparable (OR = 0.58, 95%CI 0.25-1.35, P = 0.21, I2 = 0%; MD =-0.01, 95%CI -0.16-0.15, P = 0.92, I2 = 28%). Subgroup analysis implied the effect of haloperidol on postoperative delirium might vary with the dose (5 mg daily: OR = 0.40, 95%CI 0.22-0.71, P = 0.002, I2 = 0%; <5 mg daily: OR = 0.72, 95%CI 0.42-1.23, P = 0.23, I2 = 0%).

Conclusions: The meta-analysis revealed perioperative application of haloperidol could decrease the occurrence of postoperative delirium without obvious side effects in elderly people, and high-dose haloperidol (5 mg daily) possessed a greater positive effect.

Keywords: Haloperidol; Meta-analysis; Perioperative period; Postoperative delirium.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the literature selection
Fig. 2
Fig. 2
Risk of bias in the included studies
Fig. 3
Fig. 3
The effect of haloperidol versus control on POD incidence
Fig. 4
Fig. 4
Trial sequential analysis for the effect of haloperidol versus control on POD incidence. RIS, required information size
Fig. 5
Fig. 5
The effect of haloperidol versus control on haloperidol side effects
Fig. 6
Fig. 6
The effect of haloperidol versus control on the length of hospital stay
Fig. 7
Fig. 7
Subgroup analysis for POD incidence according to dose of haloperidol
Fig. 8
Fig. 8
The funnel plot
See this image and copyright information in PMC

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