Perioperative medicine & outcomes
Transcranial Electrical Stimulation and Delirium Among Postoperative Patients: A Randomized Clinical Trial
Primary result · POD incidence in ward, tACS vs shamResult — go to the resultOdds ratio 1.60 95% CI 0.47–5.46Authors' conclusion
In this randomized clinical trial of tES for POD, there was no evidence for a uniform effect of postoperative tES on the incidence of POD, but it suggested a benefit of parietal α oscillatory enhancement for patients with longer surgery.
Study context
- Population
- Patients aged 65 years or older scheduled for elective surgery, without neurological or psychiatric disease or CNS-active medication, University Medicine Greifswald, Germany
- Participants
- 225 patients
- Comparison
- tACS vs Sham
- tACSn = 68
- Transcranial direct current stimulation (tDCS)n = 83
- Shamn = 74reference
- Primary endpoint
- POD incidence in the ward, tACS vs sham
- Follow-up
- During 1 of up to 5 postoperative days
Methodological detailsdouble-blind, sham-controlled, single-centre
- Double-blind
- Sham-controlled
- Single-centre
Primary result
POD incidence in ward, tACS vs sham
Odds ratio
1.60
95% CI 0.47–5.46
P = 0.45
Events by treatment group
tACS vs Sham
OR 1.60 (95% CI 0.47–5.46); P = 0.45
As reported in the abstract
Secondary outcomes
| Outcome | tACS | tDCS | Sham | OR (95% CI) | P value | |
|---|---|---|---|---|---|---|
| POD incidence in ward, tDCS vs sham | — not stated in the abstract | 14.3% | — not stated in the abstract | 1.51 (0.49–4.68) | P = 0.47 | |
| POD incidence in PACUtACS vs Sham | 14.6% | 21.4% | 21.7% | 0.95 (0.38–2.36) | P = 0.91 | |
| POD incidence in PACUtDCS vs Sham | 0.91 (0.36–2.30) | P = 0.83 | ||||
| POD incidence in PACU by duration of surgery (prespecified subgroup)tACS vs Sham · dependence on duration of surgery | 0.15 (0.02–0.97) | P = 0.046 | ||||
| 0.050.21520Odds ratio (log scale) |
— not stated in the abstract
- Postoperative delirium (POD) incidence in postanesthesia care unit (PACU) by duration of surgery (prespecified subgroup) — Absolute risk difference for POD, tACS vs sham, surgical duration 3 to 5 hours
- −26.6% to −46.5%
- POD incidence in ward, tDCS vs sham: tDCS 9 of 63; sham 6 of 65
- POD incidence in PACU: tACS 7 of 48; tDCS 12 of 56; sham 13 of 60
POD severity, motor type and pain levels
- No substantial difference between stimulation groups
Safety
Adverse events
| IRR (95% CI) | ||
|---|---|---|
| Between groupsDid not differ between groups | 2.3 (0.8–6.5) | |
| 0.10.31310Incidence rate ratio (log scale) |
Serious adverse events
- No serious adverse events reported
Original publication
Transcranial Electrical Stimulation and Delirium Among Postoperative Patients: A Randomized Clinical Trial. JAMA Netw Open. Published 3 August 2026. doi:10.
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