Overview
Postoperative confusion, also known as postoperative delirium, is a common complication following surgery, characterized by acute changes in mental status including disorientation, altered consciousness, and cognitive impairment. It significantly impacts patient recovery and outcomes 2041.Diagnosis
Management
Special Populations
Key Recommendations
References
Showing 100 most recent of 180 indexed papers.
1 Shamsi A, Yarahmadi S, Abolhassani Zeraat Kar A, Shahidi Delshad E. Exploring the dimensions of role transition to clinical educator among master's anaesthesia students in Iran: protocol for a sequential multimethod study (exploratory-analytical). BMJ open 2026. link 2 Reysner T, Ciftci B, Pietraszek P, Purat T, Shadi M, Musielak B et al.. Effect of intravenous dexamethasone on duration of analgesia following popliteal nerve block in pediatric ankle surgery: A randomized, triple-blinded clinical trial. Journal of clinical anesthesia 2026. link 3 Hamilton M, Mathieson S, Jamshidi M, Wang A, Lee YC, Gnjidic D et al.. Effectiveness of Interventions to Reduce Opioid Use After Orthopaedic Surgery: A Systematic Review of Randomised Controlled Trials. Drugs 2025. link 4 Jamshidi M, Jones CMP, Langford AV, Patanwala AE, Liu C, Harris IA et al.. Comparative Effectiveness of Different Opioid Regimens, in Daily Dose or Treatment Duration, Prescribed at Surgical Discharge: a Systematic Review and Meta-Analysis. CNS drugs 2025. link 5 Baumbach P, Zaslansky R, Dreiling J, Komann M, Arnold C, Stamer UM et al.. Early opioid administration and pain-related patient-reported outcomes on the first postoperative day: an analysis of data from 111,693 patients in 392 surgical wards in Germany. Pain 2025. link 6 Höök A, Hylén M, Björk M, Nilsson S, Bai J, Berlin H et al.. The Electronic Faces Thermometer Scale (eFTS)-Construct Validity for Pain Assessment in Pediatric Postoperative Care in Sweden. Paediatric anaesthesia 2025. link 7 Groenveld TD, van Dorst P, Ten Broek RPG, van Boekel RLM, van Beek RF, van der Pol S et al.. Early health economic analysis of virtual reality therapy for pain management after surgery. International journal of surgery (London, England) 2025. link 8 Vittinghoff M, Lönnqvist PA, Mossetti V, Heschl S, Simic D, Colovic V et al.. Postoperative Pain Management in children: guidance from the Pain Committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative) Part II. Anaesthesia, critical care & pain medicine 2024. link 9 Weir A. Opioid-free anaesthesia. British journal of hospital medicine (London, England : 2005) 2024. link 10 Yamakova Y, Ivanova M, Popova M, Kurtelova N, Petkov R. Quality Improvement in an Anaesthesiology and Intensive Care Unit Through Pain Assessment and Control. Nigerian journal of clinical practice 2024. link 11 Lier EJ, Smits MLM, van Boekel RLM, Vissers KCP, Maandag NJG, de Vries M et al.. Virtual reality for postsurgical pain management: An explorative randomized controlled study. Surgery 2024. link 12 Klimkiewicz J, Wysocka M, Hordowicz M, Jarosz J, Gutowski M, Paryż K et al.. Factors related to opioid misuse among patients undergoing elective surgery in Poland. Journal of addictive diseases 2024. link 13 van Rijbroek LS, Noordergraaf GJ, de Man-van Ginkel JM, van Boekel RLM. The association of hemodynamic parameters and clinical demographic variables with acute postoperative pain in female oncological breast surgery patients: A retrospective cohort study. Scandinavian journal of pain 2024. link 14 Kurita S, Sasaki M, Tanaka M, Kuwabara Y, Ogasawara Y, Baba H et al.. Analgesic effects of oral Yokukansan on acute postoperative pain and involvement of the serotonin nervous system: a mouse model study. BMC complementary medicine and therapies 2024. link 15 Yang JX, Zhang WY, Huang HH, Jiang WT, Zhou YF, Gu Y et al.. Parental involvement in postoperative pain management among children in a urology ward: A best practice implementation project. Nursing open 2023. link 16 Keane A, Jardine K, Goldenberg D, Pradhan S, Zhu J, Mansour J et al.. Opioid versus non-opioid postoperative pain management in otolaryngology. BMC anesthesiology 2023. link 17 da Silva FG, Podestá MHMC, Silva TC, de Barros CM, de Carvalho BFV, Dos Reis TM et al.. Oral pregabalin is effective as preemptive analgesia in abdominal hysterectomy-A randomized controlled trial. Clinical and experimental pharmacology & physiology 2023. link 18 Yang JX, Yao WY, Zhang F, Jiang WT, Gu Y, Xu HZ. The effectiveness of a parent participation in postoperative pain management programs for children in a urology ward: A randomized controlled trial. Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing 2022. link 19 Brase A, Brauchle D, Kermad A, Volk T, Morinello E, Gottschling S et al.. Postoperative Pain Therapy with Laser Acupuncture after Cesarean Section under Spinal Anesthesia: A Double-Blinded, Randomized, Placebo-Controlled Trial. Complementary medicine research 2022. link 20 Li S, van Boekel RLM, van den Heuvel SAS, Coenen MJH, Vissers KCP. Pain predict genetics: protocol for a prospective observational study of clinical and genetic factors to predict the development of postoperative pain. BMJ open 2022. link 21 Amend GM, Hakam N, Nabavizadeh B, Sadighian MJ, Holler JT, Rios N et al.. Institutional Opioid Prescription Guidelines are Effective in Reducing Post-Operative Prescriptions Following Urologic Surgery: Results From the American Urologic Association 2018 Census. Urology 2021. link 22 Desai N, Kirkham KR, Albrecht E. Local anaesthetic adjuncts for peripheral regional anaesthesia: a narrative review. Anaesthesia 2021. link 23 van Boekel RLM, Bronkhorst EM, Vloet L, Steegers MAM, Vissers KCP. Identification of preoperative predictors for acute postsurgical pain and for pain at three months after surgery: a prospective observational study. Scientific reports 2021. link 24 Glarcher M, Kundt FS, Meissner W, Osterbrink J. Quality Indicators (QI) of Acute Pain after Surgery in European Countries. Pain management nursing : official journal of the American Society of Pain Management Nurses 2021. link 25 Pogatzki-Zahn EM, Liedgens H, Hummelshoj L, Meissner W, Weinmann C, Treede RD et al.. Developing consensus on core outcome domains for assessing effectiveness in perioperative pain management: results of the PROMPT/IMI-PainCare Delphi Meeting. Pain 2021. link 26 van Dijk JFM, Zaslansky R, van Boekel RLM, Cheuk-Alam JM, Baart SJ, Huygen FJPM et al.. Postoperative Pain and Age: A Retrospective Cohort Association Study. Anesthesiology 2021. link 27 Wirz S, Seidensticker S, Shtrichman R. Patient-Controlled Analgesia (PCA): Intravenous Administration (IV-PCA) versus Oral Administration (Oral-PCA) by Using a Novel Device (PCoA® Acute) for Hospitalized Patients with Acute Postoperative Pain-A Comparative Retrospective Study. Pain research & management 2021. link 28 Cachemaille M, Grass F, Fournier N, Suter MR, Demartines N, Hübner M et al.. Pain Intensity in the First 96 Hours After Abdominal Surgery: A Prospective Cohort Study. Pain medicine (Malden, Mass.) 2020. link 29 Bethell J, Neuman MD, Bateman BT, Ladha KS, Hill A, Li G et al.. Association between mothers' postoperative opioid prescriptions and opioid-related events in their children: A population-based cohort study. Health reports 2020. link 30 Barreveld AM, McCarthy RJ, Elkassabany N, Mariano ER, Sites B, Ghosh R et al.. Opioid Stewardship Program and Postoperative Adverse Events: A Difference-in-differences Cohort Study. Anesthesiology 2020. link 31 Mercadante S, David F, Villari P, Spedale VM, Casuccio A. Methadone versus morphine for postoperative pain in patients undergoing surgery for gynecological cancer: A randomized controlled clinical trial. Journal of clinical anesthesia 2020. link 32 Ninagawa J, Sumitani M, Nishizawa D, Nagashima M, Mietani K, Abe H et al.. Adiponectin receptor 1 gene is potentially associated with severity of postoperative pain but not cancer pain. Medicine 2020. link 33 Lee SC, Atkinson ME, Minard CG, O'Brien A. Electronic tool helps anaesthesia trainee handovers. The clinical teacher 2019. link 34 Geißler K, Ducke M, Volk GF, Meißner W, Guntinas-Lichius O. Pain on the first postoperative day after tonsillectomy in adults: A comparison of metamizole versus etoricoxib as baseline analgesic. PloS one 2019. link 35 van den Berg AMA, Stalmeier PFM, Scheffer GJ, Hermens RP, Bucx MJL. Shared decision-making for postoperative analgesia: A semistructured qualitative study. European journal of anaesthesiology 2019. link 36 Hozumi J, Sumitani M, Nishizawa D, Nagashima M, Ikeda K, Abe H et al.. Resistin Is a Novel Marker for Postoperative Pain Intensity. Anesthesia and analgesia 2019. link 37 Mechcatie E. Duration of Postoperative Opioid Use Predicts Misuse More Than Dosage. The American journal of nursing 2018. link 38 Hofmeister EH, Barletta M, Shepard M, Brainard BM, Trim CM, Quandt J. Agreement among anesthesiologists regarding postoperative pain assessment in dogs. Veterinary anaesthesia and analgesia 2018. link 39 Vittinghoff M, Lönnqvist PA, Mossetti V, Heschl S, Simic D, Colovic V et al.. Postoperative pain management in children: Guidance from the pain committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative). Paediatric anaesthesia 2018. link 40 Pereira-Morales S, Arroyo-Novoa CM, Wysocki A, Sanzero Eller L. Acute Pain Assessment in Sedated Patients in the Postanesthesia Care Unit. The Clinical journal of pain 2018. link 41 Althaus A, Arránz Becker O, Moser KH, Lux EA, Weber F, Neugebauer E et al.. Postoperative Pain Trajectories and Pain Chronification-an Empirical Typology of Pain Patients. Pain medicine (Malden, Mass.) 2018. link 42 Russo A, Grieco DL, Bevilacqua F, Anzellotti GM, Scarano A, Scambia G et al.. Continuous intravenous analgesia with fentanyl or morphine after gynecological surgery: a cohort study. Journal of anesthesia 2017. link 43 Wirz S, Conrad S, Shtrichman R, Schimo K, Hoffmann E. Clinical Evaluation of a Novel Technology for Oral Patient-Controlled Analgesia, the . Pain research & management 2017. link 44 Rabbitts JA, Aaron RV, Zempsky WT, Palermo TM. Validation of the Youth Acute Pain Functional Ability Questionnaire in Children and Adolescents Undergoing Inpatient Surgery. The journal of pain 2017. link 45 van Boekel RLM, Vissers KCP, van der Sande R, Bronkhorst E, Lerou JGC, Steegers MAH. Moving beyond pain scores: Multidimensional pain assessment is essential for adequate pain management after surgery. PloS one 2017. link 46 Zheng H, Schnabel A, Yahiaoui-Doktor M, Meissner W, Van Aken H, Zahn P et al.. Age and preoperative pain are major confounders for sex differences in postoperative pain outcome: A prospective database analysis. PloS one 2017. link 47 Epstein HM. Postoperative Patient-Controlled Analgesia in the Pediatric Cardiac Intensive Care Unit. Critical care nurse 2017. link 48 Schnabel A, Reichl SU, Zahn PK, Pogatzki-Zahn EM, Meyer-Frießem CH. Efficacy and safety of buprenorphine in peripheral nerve blocks: A meta-analysis of randomised controlled trials. European journal of anaesthesiology 2017. link 49 Barletta M, Young CN, Quandt JE, Hofmeister EH. Agreement between veterinary students and anesthesiologists regarding postoperative pain assessment in dogs. Veterinary anaesthesia and analgesia 2016. link 50 Wioletta MD, Sebastian D, Andrzej B. Perception of barriers to postoperative pain management in elderly patients in Polish hospitals - a multicentre study. Journal of nursing management 2016. link 51 Hoogervorst-Schilp J, van Boekel RL, de Blok C, Steegers MA, Spreeuwenberg P, Wagner C. Postoperative pain assessment in hospitalised patients: National survey and secondary data analysis. International journal of nursing studies 2016. link 52 van Boekel RL, Vissers KC, van de Vossenberg G, de Baat-Ananta M, van der Sande R, Scheffer GJ et al.. Comparison of Epidural or Regional Analgesia and Patient-controlled Analgesia: A Critical Analysis of Patient Data by the Acute Pain Service in a University Hospital. The Clinical journal of pain 2016. link 53 Caumo W, Nazare Furtado da Cunha M, Camey S, Maris de Jezus Castro S, Torres IL, Cadore Stefani L. Development, psychometric evaluation and validation of a brief measure of emotional preoperative stress (B-MEPS) to predict moderate to intense postoperative acute pain. British journal of anaesthesia 2016. link 54 Bomberg H, Kubulus C, Herberger S, Wagenpfeil S, Kessler P, Steinfeldt T et al.. Tunnelling of thoracic epidural catheters is associated with fewer catheter-related infections: a retrospective registry analysis. British journal of anaesthesia 2016. link 55 Argoff C, McCarberg B, Gudin J, Nalamachu S, Young C. SoluMatrix® Diclofenac: Sustained Opioid-Sparing Effects in a Phase 3 Study in Patients with Postoperative Pain. Pain medicine (Malden, Mass.) 2016. link 56 Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T et al.. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. The journal of pain 2016. link 57 Harless M, Depp C, Collins S, Hewer I. Role of Esmolol in Perioperative Analgesia and Anesthesia: A Literature Review. AANA journal 2015. link 58 Wanderer JP, Shi Y, Schildcrout JS, Ehrenfeld JM, Epstein RH. Supervising anesthesiologists cannot be effectively compared according to their patients' postanesthesia care unit admission pain scores. Anesthesia and analgesia 2015. link 59 Heinink TP, Baker BG, Yates VF, Addison DC, Williams JP. The effect of anaesthetist grade and frequency of insertion on epidural failure: a service evaluation in a United Kingdom teaching hospital. BMC anesthesiology 2015. link 60 Bell RF, Dahl JB, Moore RA, Kalso EA. WITHDRAWN: Perioperative ketamine for acute postoperative pain. The Cochrane database of systematic reviews 2015. link 61 van Boekel RL, Steegers MA, Verbeek-van Noord I, van der Sande R, Vissers KC. Acute pain services and postsurgical pain management in the Netherlands: a survey. Pain practice : the official journal of World Institute of Pain 2015. link 62 Hobson A, Wiffen PJ, Conlon JA. As required versus fixed schedule analgesic administration for postoperative pain in children. The Cochrane database of systematic reviews 2015. link 63 Kaye AD, Ali SI, Urman RD. Perioperative analgesia: ever-changing technology and pharmacology. Best practice & research. Clinical anaesthesiology 2014. link 64 Neto JO, Machado MD, de Almeida Correa M, Scomparim HA, Posso IP, Ashmawi HA. Methadone patient-controlled analgesia for postoperative pain: a randomized, controlled, double-blind study. Journal of anesthesia 2014. link 65 Wikström L, Eriksson K, Årestedt K, Fridlund B, Broström A. Healthcare professionals' perceptions of the use of pain scales in postoperative pain assessments. Applied nursing research : ANR 2014. link 66 Eriksson K, Wikström L, Årestedt K, Fridlund B, Broström A. Numeric rating scale: patients' perceptions of its use in postoperative pain assessments. Applied nursing research : ANR 2014. link 67 van der Worp F, Stapel JT, Lako S, Hendriks J, Vissers KC, Steegers MA. The comparison of two analgesic regimes after ambulatory surgery: an observational study. Pain practice : the official journal of World Institute of Pain 2014. link 68 Lauridsen MH, Kristensen AD, Hjortdal VE, Jensen TS, Nikolajsen L. Chronic pain in children after cardiac surgery via sternotomy. Cardiology in the young 2014. link 69 Zalon ML. Mild, moderate, and severe pain in patients recovering from major abdominal surgery. Pain management nursing : official journal of the American Society of Pain Management Nurses 2014. link 70 Albrecht E, Kirkham KR, Liu SS, Brull R. Peri-operative intravenous administration of magnesium sulphate and postoperative pain: a meta-analysis. Anaesthesia 2013. link 71 Turan A, Atim A, Dalton JE, Keeyapaj W, Chu W, Bernstein E et al.. Preoperative angiotensin-converting enzyme inhibitor use is not associated with increased postoperative pain and opioid use. The Clinical journal of pain 2013. link 72 Nielsen PR, Christensen PA, Meyhoff CS, Werner MU. Post-operative pain treatment in Denmark from 2000 to 2009: a nationwide sequential survey on organizational aspects. Acta anaesthesiologica Scandinavica 2012. link 73 Schnabel A, Poepping DM, Gerss J, Zahn PK, Pogatzki-Zahn EM. Sex-related differences of patient-controlled epidural analgesia for postoperative pain. Pain 2012. link 74 Mathiesen O, Thomsen BA, Kitter B, Dahl JB, Kehlet H. Need for improved treatment of postoperative pain. Danish medical journal 2012. link 75 Bates C, Laciak R, Southwick A, Bishoff J. Overprescription of postoperative narcotics: a look at postoperative pain medication delivery, consumption and disposal in urological practice. The Journal of urology 2011. link 76 Ozgencil E, Yalcin S, Tuna H, Yorukoglu D, Kecik Y. Perioperative administration of gabapentin 1,200 mg day-1 and pregabalin 300 mg day-1 for pain following lumbar laminectomy and discectomy: a randomised, double-blinded, placebo-controlled study. Singapore medical journal 2011. link 77 Tait AR, Voepel-Lewis T, Zikmund-Fisher BJ, Fagerlin A. Presenting research risks and benefits to parents: does format matter?. Anesthesia and analgesia 2010. link 78 Mercadante S. Intravenous patient-controlled analgesia and management of pain in post-surgical elderly with cancer. Surgical oncology 2010. link 79 Roy YM, Derry S, Moore RA. Single dose oral lumiracoxib for postoperative pain in adults. The Cochrane database of systematic reviews 2010. link 80 Powell AE, Davies HT, Bannister J, Macrae WA. Challenge of improving postoperative pain management: case studies of three acute pain services in the UK National Health Service. British journal of anaesthesia 2009. link 81 Coluzzi F, Savoia G, Paoletti F, Costantini A, Mattia C. Postoperative pain survey in Italy (POPSI): a snapshot of current national practices. Minerva anestesiologica 2009. link 82 El-Rakshy M, Clark SC, Thompson J, Thant M. Effect of intraoperative electroacupuncture on postoperative pain, analgesic requirements, nausea and sedation: a randomised controlled trial. Acupuncture in medicine : journal of the British Medical Acupuncture Society 2009. link 83 Shroff PP, Kaushal V, Kamdar BM. Comparative study of postoperative analgesia and sedation after upper abdominal surgery with thoracic epidural administration of bupivacaine with/without midazolam. Journal of the Indian Medical Association 2009. link 84 Schein JR, Hicks RW, Nelson WW, Sikirica V, Doyle DJ. Patient-controlled analgesia-related medication errors in the postoperative period: causes and prevention. Drug safety 2009. link 85 Chan SK, Chui PT, Lee A, Lai PB, Li TY, Gin T. Surgeons' attitudes and perception of an acute pain service. Hong Kong medical journal = Xianggang yi xue za zhi 2008. link 86 Alves MM, Carvalho PR, Wagner MB, Castoldi A, Becker MM, Silva CC. Cross-validation of the Children's and Infants' Postoperative Pain Scale in Brazilian Children. Pain practice : the official journal of World Institute of Pain 2008. link 87 Terry RH, Niven CA, Brodie EE, Jones RB, Prowse MA. Memory for pain? A comparison of nonexperiential estimates and patients' reports of the quality and intensity of postoperative pain. The journal of pain 2008. link 88 Machata AM, Illievich UM, Gustorff B, Gonano C, Fässler K, Spiss CK. Remifentanil for tracheal tube tolerance: a case control study. Anaesthesia 2007. link 89 Carrer S, Bocchi A, Candini M, Donegà L, Tartari S. Short term analgesia based sedation in the Intensive Care Unit: morphine vs remifentanil + morphine. Minerva anestesiologica 2007. link 90 Lentschener C, Tostivint P, White PF, Gentili ME, Ozier Y. Opioid-induced sedation in the postanesthesia care unit does not insure adequate pain relief: a case-control study. Anesthesia and analgesia 2007. link 91 Bucknall T, Manias E, Botti M. Nurses' reassessment of postoperative pain after analgesic administration. The Clinical journal of pain 2007. link 92 Mitchinson AR, Kim HM, Rosenberg JM, Geisser M, Kirsh M, Cikrit D et al.. Acute postoperative pain management using massage as an adjuvant therapy: a randomized trial. Archives of surgery (Chicago, Ill. : 1960) 2007. link 93 Roy YM, Derry S, Moore RA. Single dose oral lumiracoxib for postoperative pain. The Cochrane database of systematic reviews 2007. link 94 Kawaraguchi Y, Otomo T, Ota C, Uchida N, Taniguchi A, Inoue S. A prospective, double-blind, randomized trial of caudal block using ropivacaine 0.2% with or without fentanyl 1 microg kg-1 in children. British journal of anaesthesia 2006. link 95 Müller C, Kremer W, Harlfinger S, Doroshyenko O, Jetter A, Hering F et al.. Pharmacokinetics of piritramide in newborns, infants and young children in intensive care units. European journal of pediatrics 2006. link 96 Coll AM, Ameen J. Profiles of pain after day surgery: patients' experiences of three different operation types. Journal of advanced nursing 2006. link 97 Stamer UM, Mpasios N, Maier C, Stuber F. Postoperative analgesia in children--current practice in Germany. European journal of pain (London, England) 2005. link 98 Akinci SB, Kanbak M, Guler A, Aypar U. Remifentanil versus fentanyl for short-term analgesia-based sedation in mechanically ventilated postoperative children. Paediatric anaesthesia 2005. link 99 Ong CK, Lirk P, Tan JM, Sow BW. The analgesic efficacy of intravenous versus oral tramadol for preventing postoperative pain after third molar surgery. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2005. link 100 Goldstein DH, VanDenKerkhof EG, Blaine WC. Acute pain management services have progressed, albeit insufficiently in Canadian academic hospitals. Canadian journal of anaesthesia = Journal canadien d'anesthesie 2004. link