Nonpharmacological Interventions to Prevent Postoperative Delirium and Agitation Among Children: A Systematic Review.

Researchers recently reviewed studies on non-drug approaches to prevent confusion and agitation in children after surgery, a condition called postoperative delirium. This systematic review examined research published from 2000 to January 2025, searching six major medical databases and ultimately analyzing 10 studies that met their criteria.

The review found that several simple interventions can effectively reduce postoperative delirium in children. Letting children suck on lollipops, playing recordings of their mother's voice, covering their eyes during recovery, and using special monitoring to guide anesthesia dosing all showed significant benefits in preventing confusion and agitation after surgery. However, some approaches that researchers hoped would help—like using tablets or virtual reality—did not show clear benefits in the studies reviewed.

Interestingly, the review mentioned that acupuncture, specifically electrical stimulation of an acupuncture point called Heart 7, might help prevent emergence delirium in children. However, the researchers concluded that more studies are needed to confirm whether this acupuncture technique is truly effective for this purpose.

For parents considering options to help their child have a calmer recovery after surgery, this review suggests that proven non-drug approaches like maternal voice recordings and lollipops may be worth discussing with the surgical team. While acupuncture shows promise based on traditional use and some preliminary evidence, the scientific evidence for preventing postoperative delirium specifically is not yet strong enough to make definitive recommendations. If you're interested in exploring acupuncture for your child, it's important to work with a licensed acupuncturist experienced in pediatric care.

This systematic review analyzed 10 studies (from 1,300 initially screened) examining nonpharmacological interventions for postoperative delirium and agitation in pediatric populations. The search covered six databases from 2000 to January 2025, including randomized controlled trials and quasi-experimental designs. Significant reductions in postoperative delirium were observed with lollipop sucking, maternal voice recordings, eye-covering techniques, and bispectral index-guided anesthesia. Tablet use and virtual reality exposure did not demonstrate statistically significant benefits (P > .05). The review noted that acupuncture electrical stimulation at the Heart 7 (HT-7) acupuncture point requires further investigation to establish efficacy for preventing emergence delirium in children. Clinical takeaway: While several simple nonpharmacological interventions show promise for reducing pediatric postoperative delirium, the evidence for acupuncture remains preliminary. Practitioners should focus on validated interventions while remaining open to emerging research on electroacupuncture applications in this population.