Systematic Summary of Best Evidence for Preventing Delayed Recovery After General Anesthesia in Older Patients

To summarize the best evidence for preventing delayed recovery (DR) after general anesthesia in older patients.

Summary of best evidence.

A comprehensive literature search was conducted in both Chinese and international databases to identify evidence on preventing DR after general anesthesia in older patients. The databases searched included BMJ Best Practice, UpToDate, Joanna Briggs Institute, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, The Association of Perioperative Registered Nurses, American Society of Anesthesiologists, Canadian Anesthetists Society, Cochrane Library, PubMed, Medlive, Chinese Anesthesia website, China National Knowledge Infrastructure, and Wanfang Data. The search encompassed clinical decisions, guidelines, evidence summaries, systematic reviews, and expert consensus statements, spanning from the establishment of the database to September 2024. Two reviewers independently screened and evaluated the literature, and then extracted and summarized the evidence according to the Joanna Briggs Institute Grades of Recommendation and Levels of Evidence.

A total of 13 articles were included, namely 3 clinical decisions, 5 guidelines, and 5 expert consensus statements. Thirty-one best evidence points were derived across nine areas, including preoperative assessment, brain protection strategies, fluid management, circulation management, respiratory management, temperature regulation, internal environment stabilization, neuromuscular monitoring, and recovery management.

The integration and clinical application of best evidence by health care professionals can reduce the incidence of DR after general anesthesia in older patients.