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

Peiman Prandeh Afshar1, Fatemeh Dehghan2, Eied Saber Alamain Ali3

  • 1Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses
|February 28, 2026
PubMed

Insights

Nonpharmacological methods like lollipop sucking and maternal voice recordings can help prevent postoperative delirium in children. Other interventions, such as virtual reality, require further investigation.

Area of Science:

  • Pediatric Anesthesiology
  • Evidence-Based Practice
  • Child Psychology

Background:

  • Postoperative delirium and agitation are common concerns in pediatric patients.
  • Nonpharmacological interventions offer a promising avenue for managing these adverse events.
  • Identifying effective strategies is crucial for improving pediatric surgical outcomes.

Purpose of the Study:

  • To systematically review nonpharmacological interventions for preventing postoperative delirium and agitation in children.
  • To synthesize evidence from randomized controlled trials and quasi-experimental studies.
  • To identify interventions with proven efficacy and those requiring further research.

Main Methods:

  • Systematic review of randomized controlled trials and quasi-experimental studies (2000-2025).
  • Searched six major databases (Web of Science, Scopus, PubMed, EMBASE, Cochrane, Google Scholar).
  • Included 10 studies after screening 1,300 titles and abstracts.

Main Results:

  • Lollipop sucking, maternal voice recordings, eye-covering techniques, and bispectral index-guided anesthesia significantly reduced postoperative delirium.
  • Tablet use and virtual reality exposure did not demonstrate significant benefits (P > .05).
  • Further research is needed for acupuncture electrical stimulation of the heart 7 acupuncture point.

Conclusions:

  • Nonpharmacological interventions including lollipop sucking, maternal voice, bispectral index-guided anesthesia, and eye covering show potential in reducing pediatric postoperative delirium.
  • Interventions like tablets and virtual reality require additional study to determine their effectiveness.
  • More research is essential to validate the efficacy of acupuncture and other novel methods for preventing emergence delirium.
Abstract

Keywords:
agitationchildrendeliriumnonpharmacologicalpostoperative

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