Yokukansan (TJ-54) in patients undergoing surgery: A systematic review and meta-analysis

Objectives: To evaluate the efficacy and safety of Yokukansan (TJ-54) in patients undergoing surgery.Methods: Efficacy was assessed by the onset of delirium, delirium rating scales, anxiety evaluated by Hospital Anxiety and Depression Scale-Anxiety (HADS-A) score, and safety was assessed by any reported adverse events.Results: Six studies were included. There were no significant differences between the groups in the onset of delirium (risk ratio 1.15, 95% confidence interval [CI] 0.77-1.72), delirium rating scales (early postoperative period: standardized mean difference [SMD]-0.24, 95% CI-1.11 to 0.63; late postoperative period: SMD-0.06, 95% CI-1.56 to 1.45), HADS-A score (mean difference-0.47, 95% CI-1.90 to 0.96), and any adverse events (risk ratio 1.18, 95% CI 0.35-4.00).Conclusions: The use of TJ-54 in patients undergoing surgery is not an effective strategy for postoperative delirium and anxiety. Further research considering target patients and durations of administration should be conducted.(c) 2023 Elsevier Inc. All rights reserved.