Perioperative medicine & outcomes
Effect of perioperative benzodiazepine use on intraoperative awareness and postoperative delirium: a systematic review and meta-analysis of randomised controlled trials and observational studies
Authors' conclusion
In this systematic review and meta-analysis, perioperative benzodiazepine use did not increase postoperative delirium and decreased intraoperative awareness.
Study context
- Population
- Patients undergoing surgery
- Participants
- 4,354 patients · 34 RCTs
- Comparison
- Perioperative benzodiazepines vs other agents or placebo
- Outcome
- Delirium, intraoperative awareness, and mortality
Methodological detailsrandom-effects model, observational studies considered separately
- Random-effects model
- Observational studies considered separately
Pooled result
As reported in the abstract
Delirium, intraoperative awareness and mortality (primary outcomes)
Benzodiazepines vs Other agents or placeboRelative risk (95% CI)P value
Delirium; n=1352; I2=72%; very low-quality evidence
1.43(0.9–2.27)
P = 0.13Intraoperative awareness; n=2245; I2=35%; very low-quality evidence
0.26(0.12–0.58)
P = 0.001Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Delirium, benzodiazepines vs dexmedetomidine (subgroup)5 studies; n=429; I2=13% | 1.83 (1.24–2.72) | P = 0.002 | |
| No intraoperative awareness (non-events)I2=98%; very low-quality evidence | 1.07 (1.01–1.13) | P = 0.03 | |
| 0.20.5125Relative risk (log scale) |
Original publication
Effect of perioperative benzodiazepine use on intraoperative awareness and postoperative delirium: a systematic review and meta-analysis of randomised controlled trials and observational studies. Br J Anaesth. Published 6 January 2023. doi:10.
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