Perioperative non-invasive brain stimulation for the prevention of postoperative delirium: a systematic review and meta-analysis of randomised controlled trials

Perioperative non-invasive brain stimulation is linked to lower postoperative delirium in adults across nine randomized trials (1451 participants), with RR 0.41 (95% CI 0.31–0.56).

• Why it matters: Postoperative delirium is common and early trials conflicted with the recent MODEST trial, leaving uncertainty about whether stimulation truly prevents delirium.
• What they did: The authors searched eight databases and ClinicalTrials.gov to 30 September 2026 for randomized controlled trials in adults, then pooled outcomes using random-effects meta-analysis and assessed bias with RoB 2 and certainty with GRADE.
• The result: Delirium subtypes showed favorable but less consistent effects (hypoactive and hyperactive; mixed not clearly), while pain, anxiety, and sleep favored stimulation with very-low certainty; hospital stay was not reduced.

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