Date of Completion

Fall 12-13-2023

Project Type

Integrative Review

Degree Name

Surgical Review



Committee Chair/First Advisor

Dr. Doreen Wagner


Introduction: As patients recover from surgery, it has been recognized that anesthetic agents are an external risk factor for the development of acute postoperative delirium. Postoperative delirium (POD) manifests as inattention with changes in perception or cognition, altered levels of consciousness, and changes in motor activity such as agitation or lethargy up to seven days after surgery. POD is linked to increased morbidity and mortality, prolonged hospitalizations and recovery, and persistent cognitive decline.

Purpose: The purpose of this integrative review was to determine which anesthetic agents decrease the risk of postoperative delirium (POD) development in adult non-cardiac surgical patients.

Methods: We used the database PubMed and an integrative review methodology to appraise evidence related to POD and anesthetic agents. To guide the integrative review process, we followed the five-stage framework of Whittemore and Knafl and used the organizing tools from the John Hopkins Nursing Evidence Based Practice Model (JHNEBP).

Results: The initial search of POD produced 5,668 articles in the PubMed database. After further comprehensive search approaches, we identified 20 articles that met our inclusion criteria. The anesthetic agent propofol emerged as the foremost agent to decrease the risk of patients developing POD.

Discussion: Based on this review, all anesthetic agents are associated with the incidence of POD, however propofol was associated with less delirium incidence. Varied terms for POD, different types of delirium assessment approaches, and a range of anesthetic dosages for sedation depth were issues noted during the review.

Conclusion: This integrative review adds to the evidence about POD and the potential for anesthetic choices for adult non-cardiac surgical patients. Future research with larger sample sizes using comparable methods is needed to provide more support that propofol is the best anesthetic agent to use in the prevention of POD.

Included in

Nursing Commons