{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T12:55:29Z","timestamp":1770468929026,"version":"3.49.0"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation","award":["2024L004"],"award-info":[{"award-number":["2024L004"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Postoperative delirium (POD) is a common complication in elderly patients, linked to prolonged hospitalization, increased morbidities, and mortality. Midazolam, a widely used perioperative benzodiazepine, has controversial associations with POD: some studies suggest risks, while others find no significant link, but evidence quality remains low. This trial explores whether midazolam is non-inferior to placebo in POD incidence among elderly spinal surgery patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>A single-center, randomized, double-blind, placebo-controlled non-inferiority trial at Ningbo No. 6 Hospital, China, enrolling 692 elderly patients undergoing elective spinal surgery under general anesthesia. Exclusions include emergency surgery, long-term preoperative benzodiazepine use, and severe cognitive impairment. Participants are randomized 1:1 to receive midazolam (2 mg) or placebo (saline) during induction, via sealed envelopes. Blinding is maintained except for the preparing nurse. Primary outcome: POD incidence assessed by Evaluation tool: Confusion Assessment Method (CAM) on postoperative days 1\u20133. Secondary outcomes include POD details, agitation (Richmond scale), pain (NRS), lab indicators, hospital stay, and complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0339537","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T18:36:51Z","timestamp":1770403011000},"page":"e0339537","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Protocol: Effects of midazolam on postoperative delirium in elderly patients undergoing spinal surgery: A randomized, double-blind, placebo-controlled non-inferiority 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