Effectiveness of interventions delivered within inpatient perioperative care in adults undergoing surgery: scoping review of systematic reviews

Abstract Background Many perioperative interventions have been developed to improve care and health outcomes for patients. Interventions that are effective, reduce adverse events, and improve patient recovery are hugely important to patients and healthcare systems. This study provides a contemporary overview of the effectiveness of interventions delivered within inpatient perioperative care in adults undergoing surgery. Methods A scoping review of systematic reviews (SRs) was performed according to Joanna Briggs Institute methodology and PRISMA-ScR guidelines. The following databases were searched: Medline, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and Physiotherapy Evidence Database, last update 2 December 2025. Results In all, 190 SRs were included in the review, incorporating 10 themes: enhanced recovery after surgery (ERAS; 77 SRs, 39%); diet/nutritional (31 SRs; 16%); pharmaceutical (20 SRs, 10.8%); respiratory (15 SRs, 8.5%); ‘other’ (e.g. sleep, body warming and personalized nursing interventions, goal directed haemodynamic and acupuncture therapy) (13 SRs, 7.4%); exercise/physical activity (12 SRs, 6.5%); comprehensive geriatric assessment (CGA; 9 SRs, 4.5%); care bundles (5 SRs, 2.8%); multimodal (5 SRs, 2.8%); and physiotherapy (3 SRs, 1.7%). Key intervention themes showed consistent benefit across a range of surgical specialities. These consisted of: respiratory/aerobic strategies on length of hospital stay (LoS), postoperative complications, and the 6-minute walk test, with little evidence for effect on mortality; diet/nutritional strategies, which had significant benefits with regard to LoS, postoperative complications, and surgical site infections, with little or no effect on mortality; CGA, which had a beneficial effect on mortality, LoS, and activities of daily living, with little evidence of effect on readmission; and ERAS, which showed improvements in LoS, postoperative complications, and morbidity, with less evidence of effect on mortality and readmission across specialities. Conclusions Key interventions showed consistent patterns of improvement. Before improving or designing new perioperative interventions, it is important to consider and deliver strategies that have already been evaluated and are effective.