Development of a comprehensive peri-anaesthetic bundle of postoperative delirium interventions for thoracic surgery patients: a Delphi method consensus study

Postoperative delirium (POD) is a preventable complication that can prolong hospitalisation and increase healthcare costs. This study aimed to establish a streamlined and comprehensive peri-anaesthetic bundle of interventions to prevent postoperative delirium in patients undergoing thoracic surgery. A multidisciplinary team of experts was convened, and the Delphi method was used to develop bundle strategies. An initial intervention questionnaire was formulated based on a literature review. Two to three rounds of expert consultations were performed to finalise the prevention strategy. A panel of 12 experts was convened. After two rounds of consultation, an initial version of the peri-anaesthetic bundle was developed. The main content comprised four programmes: perioperative neurocognitive function assessment and cognitive function exercises, perioperative pain management with multimodal analgesia, intraoperative anaesthesia management, and post-anaesthesia recovery management. A peri-anaesthetic bundle for patients undergoing thoracic surgery was developed using the Delphi method. Clinical trials should be conducted to confirm its effectiveness and to offer a new approach for preventing POD.