Only a minority of patients with postoperative delirium will have a single, reversible etiology for their condition (see Delirium, Chapter 4). Evaluation of delirious patients should exclude electrolyte derangements, occult UTI, and adverse effects from psychotropic medications such as opioids, sedatives, anticholinergic agents, and antispas­modics. Conservative management includes reassuring and reorienting the patient; eliminating unneeded medica­tions, intravenous lines, and urinary catheters; and keeping the patient active during the day while allowing uninter­rupted sleep at night. Use of multimodal postoperative analgesic strategies can reduce or avoid the need for opi­oids. Scheduled administration of non-opiate analgesics such as acetaminophen or NSAID in the absence of contra­indications often forms the core of these techniques. The analgesic effect of both opioid and non-opioid analgesics can be augmented by medications, such as gabapentin, which targets neuropathic pain; local or regional anesthetic agents; and nonpharmacologic approaches such as cognitive-behavioral therapy. When agitation jeopardizes patient or provider safety, neuroleptic agents given at the lowest effective dose for the shortest duration needed are preferred over the use of benzodiazepines or physical restraints (Table 27–1).