The effect of haloperidol’s perioperative application on postoperative delirium in elderly patients: a systematic review and meta-analysis

To systematically review the evidence about the effect of haloperidol on postoperative delirium in elderly patients.

PubMed, Embase, the Cochrane Library and China National Knowledge Infrastructure were used to find concerned studies for meta-analysis. The main outcome was the incidence of postoperative delirium, and the secondary outcomes were side effects of haloperidol and the length of hospital stay. The meta-analyses were conducted using the Review Manager Version 5.1. This study was conducted based on the PRISMA statement.

Eight RCTs (1569 patients) were included in the meta-analysis. There was a significant difference in the incidence of postoperative delirium between haloperidol and control groups (OR = 0.62, 95%CI 0.48–0.80, P = 0.0002, I² = 20%). In addition, side effects of haloperidol and the duration of hospitalization were comparable (OR = 0.58, 95%CI 0.25–1.35, P = 0.21, I² = 0%; MD =-0.01, 95%CI -0.16-0.15, P = 0.92, I² = 28%). Subgroup analysis implied the effect of haloperidol on postoperative delirium might vary with the dose (5 mg daily: OR = 0.40, 95%CI 0.22–0.71, P = 0.002, I² = 0%; <5 mg daily: OR = 0.72, 95%CI 0.42–1.23, P = 0.23, I² = 0%).

The meta-analysis revealed perioperative application of haloperidol could decrease the occurrence of postoperative delirium without obvious side effects in elderly people, and high-dose haloperidol (5 mg daily) possessed a greater positive effect.