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Innovations in Perioperative Anesthesia: Advancing Non-Operating Room Anesthesia (NORA) and Regional Techniques

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: 20 February 2026 | Viewed by 3453

Special Issue Editors

Dr. Francesco Coppolino

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Guest Editor
Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80134 Naples, Italy
Interests: non operative room anesthesia; anesthesia and regional anesthesia; nerve block; spinal anesthesia; postoperative pain; perioperative medicine; intensive care medicine
Special Issues, Collections and Topics in MDPI journals
Dr. Vincenzo Pota

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Guest Editor
Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80134 Naples, Italy
Interests: non operative room anesthesia; anesthesia and regional anesthesia; nerve block; spinal anesthesia; postoperative pain; perioperative medicine; intensive care medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Perioperative medicine is evolving rapidly, driven by the growing complexity of surgical procedures and patient populations. In this context, anesthesia care is expanding beyond the traditional operating room, with non-operating room anesthesia (NORA) emerging as a critical domain requiring tailored approaches to safety, monitoring, and anesthetic technique. Concurrently, ultrasound-guided regional anesthesia, including peripheral nerve blocks and fascial plane blocks, has become a cornerstone in perioperative pain management, offering enhanced analgesia, reduced opioid consumption, and improved recovery profiles across diverse surgical settings. 

This Special Issue aims to explore current challenges and innovations in perioperative anesthesia, with a focus on NORA and regional techniques. We invite contributions that address clinical, organizational, and technical aspects of anesthesia care in non-traditional settings, as well as research into the efficacy and safety considerations of ultrasound-guided blocks. Emphasis will also be placed on multidisciplinary strategies to optimize perioperative outcomes through evidence-based analgesia protocols and personalized anesthesia planning.

We welcome original research and reviews that advance our understanding and practice in this dynamic field.

You may choose our Joint Special Issue in Healthcare.

Dr. Francesco Coppolino
Dr. Vincenzo Pota
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • perioperative medicine
  • non-operating room anesthesia (NORA)
  • ultrasound-guided regional anesthesia
  • fascial plane blocks
  • postoperative pain management

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Published Papers (1 paper)

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Review

18 pages, 274 KB  
Review
Regional Anesthesia: A Narrative Review of Impact on Oxidative Stress Biomarkers
by Karolina Jaruga, Anna Puścion-Jakubik and Piotr Jakubów
J. Clin. Med. 2025, 14(21), 7503; https://doi.org/10.3390/jcm14217503 - 23 Oct 2025
Viewed by 244
Abstract
Background/Objectives: Oxidative stress results from an imbalance between reactive oxygen species (ROS) production and antioxidant defenses and has been implicated in the pathogenesis of numerous diseases, including cardiovascular and neurodegenerative disorders. In the perioperative setting, both surgical trauma and anesthetic agents may [...] Read more.
Background/Objectives: Oxidative stress results from an imbalance between reactive oxygen species (ROS) production and antioxidant defenses and has been implicated in the pathogenesis of numerous diseases, including cardiovascular and neurodegenerative disorders. In the perioperative setting, both surgical trauma and anesthetic agents may contribute to oxidative stress. While this phenomenon has been extensively studied under general anesthesia, the role of regional anesthesia remains less defined. This review aims to compare the impact of general and regional anesthesia techniques on oxidative stress and its biomarkers across various surgical disciplines. Methods: A literature search was conducted using PubMed and EBSCO databases, focusing on studies published between 2010 and 2024. Search terms included “anesthesiology”, “oxidative stress”, “regional anesthesia”, “general anesthesia”, and related biomarkers (e.g., MDA, TAS, TOS, thiol/disulfide). Inclusion criteria required that studies compare general and regional anesthesia techniques and assess at least one biomarker of oxidative stress. Seventeen studies were included in the final analysis. Results: Findings were heterogeneous. Some studies reported that regional anesthesia, particularly spinal and peripheral nerve blocks, was associated with lower levels of malondialdehyde (MDA), reduced total oxidant status (TOS), and improved total antioxidant status (TAS), suggesting reduced oxidative stress. In contrast, other studies showed higher levels of oxidative stress markers under regional anesthesia or no significant differences between techniques. Outcomes varied by surgical type, biomarker used, patient population, and methodological quality. Conclusions: Current evidence is insufficient to establish definitive recommendations regarding the choice of anesthetic technique based on oxidative stress outcomes. However, regional anesthesia appears to be associated with a more favorable oxidative profile in some settings, such as cesarean section and selected orthopedic procedures. Further standardized, large-scale studies are needed to clarify these findings and guide anesthetic decision-making in the context of oxidative balance. Full article
(This article belongs to the Special Issue Innovations in Perioperative Anesthesia: Advancing Non-Operating Room Anesthesia (NORA) and Regional Techniques)
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