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Advances in Perioperative Anesthesia: Emerging Techniques and Clinical Practices
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Advances in Perioperative Anesthesia: Emerging Techniques and Clinical Practices

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

Deadline for manuscript submissions: 20 July 2026 | Viewed by 1873

Special Issue Editors

Dr. Mitchell H. Tsai

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Guest Editor
Department of Anesthesiology and Perioperative Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
Interests: perioperative anesthesia; regional anesthesia; anesthesiology; anesthetic management; clinical anesthesia
Dr. Matthew Bergeron Allen

E-Mail Website
Guest Editor
Department of Anesthesiology, Brigham and Women’s Hospital, MassGeneral Brigham, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
Interests: geriatric anesthesia; frailty; serious illness communication; decision making; ethics; cardiopulmonary resuscitation; thoracic anesthesia
Dr. Roya Saffary

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Guest Editor
Department of Anesthesiology, Perioperative and Pain Medicine, Stanford Health Care Department of Anesthesiology, The Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT 05405, USA
Interests: perioperative anesthesia; anesthesia management; operating room management; artificial intelligence; innovation

Special Issue Information

Dear Colleagues,

Perioperative anesthesia has evolved far beyond the traditional confines of the operating room, with an increasing emphasis on comprehensive patient pathways—from preoperative optimization to intraoperative management and postoperative recovery. This Special Issue seeks to highlight the emerging frontiers that are reshaping perioperative medicine and transforming contemporary anesthetic practice.

We aim to showcase key innovations, evolving clinical approaches, and advanced technologies that support safer, more individualized, and more effective perioperative care. In particular, this Special Issue welcomes high-quality original research and authoritative reviews that explore novel anesthetic strategies and technological advancements across the peri-anesthesia continuum.

Submissions that offer new insights or demonstrate measurable improvements in perioperative outcomes are especially encouraged. We look forward to receiving your contributions and to advancing the science and practice of perioperative anesthesia together.

Dr. Mitchell H. Tsai
Dr. Matthew Bergeron Allen
Dr. Roya Saffary
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 250 words) can be sent to the Editorial Office for assessment.

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
  • goal-concordant care
  • anesthesia co-management
  • postoperative outcomes
  • perioperative anesthesia

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

13 pages, 919 KB  
Article
Who Needs Most? Multicenter Subanalysis of Blood Transfusion Profiles in the German Patient Blood Management Network Registry
by Florian Rumpf, Suma Choorapoikayil, Lotta Hof, Denana Mehic, Philipp Helmer, Benedikt Schmid, Kai Zacharowski, Patrick Meybohm and German Patient Blood Management Network Collaborators
J. Clin. Med. 2026, 15(5), 1759; https://doi.org/10.3390/jcm15051759 - 26 Feb 2026
Viewed by 530
Abstract
Background: Blood transfusion practices have evolved significantly in order to enhance patient care. The optimal strategies for administering red blood cell (RBC) transfusions is becoming rather clear; however, a comprehensive understanding of patients requiring transfusions of other blood components remains inadequate, leading [...] Read more.
Background: Blood transfusion practices have evolved significantly in order to enhance patient care. The optimal strategies for administering red blood cell (RBC) transfusions is becoming rather clear; however, a comprehensive understanding of patients requiring transfusions of other blood components remains inadequate, leading to variability in clinical practice and outcomes. Here we examine surgical patients that could benefit from perioperative risk stratification. Study Design and Methods: We analyzed subgroups of a prospective, multicenter follow-up study and identified three distinct transfusion profiles across surgical disciplines: low (n = 1,035,588, 92.0%), moderate (n = 81,243, 7.2%), and high (n = 8413, 0.7%). These profiles are characterized by varying requirements for RBC, plasma, and platelet units. Results: While most patients were clustered in the low transfusion profile, blood component use only increased significantly in the high transfusion profile. Notably, patients in the high transfusion profile benefited from Patient Blood Management (PBM) interventions with a reduction of the predefined composite endpoint of in-hospital mortality and postoperative complications (ischemic stroke, myocardial infarction, pneumonia, sepsis and acute renal failure with renal replacement therapy) from 28.2% to 26.0% and an OR of 0.90 (95% CI 0.80–1.00, p = 0.048) compared to the moderate transfusion profile. Conversely, the low transfusion profile encompassed patients with minimal transfusion needs, presenting opportunities to refine resource allocation and risk stratification. Discussion: These findings underscore the potential for improving patient outcomes and indicate that implementing targeted PBM interventions can reduce the risk of adverse events and mortality. This study advances the field by identifying specific transfusion profiles that can guide future research and clinical practices towards more personalized and efficient blood management in perioperative care. Full article
(This article belongs to the Special Issue Advances in Perioperative Anesthesia: Emerging Techniques and Clinical Practices)
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16 pages, 799 KB  
Article
Association Between Entropy Monitoring, Burst Suppression and Early Postoperative Cognitive Dysfunction in Emergency Surgery: A Retrospective Cohort Study
by Liliana Mirea, Ana Maria Dumitriu, Cristian Cobilinschi, Bogdan Cristian Dumitriu, Raluca Ungureanu, Cosmin Andrei Andrei, Răzvan Ene, Dragoș Ene, Radu Țincu and Ioana Marina Grințescu
J. Clin. Med. 2026, 15(3), 968; https://doi.org/10.3390/jcm15030968 - 25 Jan 2026
Viewed by 568
Abstract
Background/Objectives: Emergency surgical patients are at increased risk of acute postoperative delirium. Processed EEG monitoring, such as entropy indices and burst suppression ratio (BSR), may optimize anesthetic dosing, yet their role in non-elective surgery remains underexplored. This retrospective cohort study aimed to examine [...] Read more.
Background/Objectives: Emergency surgical patients are at increased risk of acute postoperative delirium. Processed EEG monitoring, such as entropy indices and burst suppression ratio (BSR), may optimize anesthetic dosing, yet their role in non-elective surgery remains underexplored. This retrospective cohort study aimed to examine whether entropy monitoring and intraoperative burst suppression are associated with the incidence of early postoperative delirium during the first 72 h after emergency surgery. Methods: Adult patients undergoing emergency surgery between March 2022 and March 2024 were classified into two groups based on anesthesia records: the entropy-monitored group (EG) and the standard care group without processed EEG (SG). Demographic, intraoperative, and cognitive data (NEECHAM scores during the first 72 h) were extracted from institutional perioperative records. The primary outcome was postoperative delirium (NEECHAM ≤ 24), with secondary analyses examining anesthetic exposure, burst suppression, and intraoperative hemodynamics. Results: Entropy-monitored patients received lower sevoflurane and fentanyl doses and exhibited improved hemodynamic stability, including fewer hypotensive episodes and lower norepinephrine requirements. Early postoperative cognitive dysfunction (NEECHAM ≤ 24) was more frequent among patients with intraoperative burst suppression, with BSR > 15% or suppression duration > 6 min strongly associated with cognitive decline within the first 72 h. Conclusions: In this retrospective cohort, entropy-guided anesthesia was associated with more precise anesthetic titration and more stable hemodynamic parameters. Burst suppression characteristics may serve as indicators of neurocognitive vulnerability rather than solely reflecting direct effects of anesthetic dosing. These results support the use of processed EEG monitoring in emergency surgery, though prospective studies are needed to confirm these findings. Full article
(This article belongs to the Special Issue Advances in Perioperative Anesthesia: Emerging Techniques and Clinical Practices)
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11 pages, 2005 KB  
Article
Comprehensive Tracheobronchial Morphometry in Korean Adults: Clinical Implications for Double-Lumen Tube Sizing and Right Upper Lobe Alignment
by Seihee Min, Youn Joung Cho and Jae-Hyon Bahk
J. Clin. Med. 2026, 15(1), 318; https://doi.org/10.3390/jcm15010318 - 1 Jan 2026
Viewed by 395
Abstract
Background/Objectives: Accurate knowledge of tracheobronchial anatomy is essential for safe airway management, particularly during one-lung ventilation using double-lumen tubes (DLTs). However, population-specific morphometric data in Asian adults remain limited. We aimed to establish a comprehensive morphometric profile of the tracheobronchial tree in Korean [...] Read more.
Background/Objectives: Accurate knowledge of tracheobronchial anatomy is essential for safe airway management, particularly during one-lung ventilation using double-lumen tubes (DLTs). However, population-specific morphometric data in Asian adults remain limited. We aimed to establish a comprehensive morphometric profile of the tracheobronchial tree in Korean adults using 2D and 3D computed tomography (CT), and evaluate the clinical implications for DLT sizing and right upper lobe (RUL) alignment. Methods: This retrospective observational study included 398 adults who underwent preoperative chest CT. Measurements included tracheal dimensions, bronchial lengths, bronchial diameters, and anteroposterior angle of the RUL orifice. Height tertiles and sex-stratified linear regression analyses were performed to evaluate height–bronchial diameter relationships. Results: Bronchial dimensions were larger in men; however, height was more closely related to bronchial diameter in women. In women, each 1 cm increase in height corresponded to a 0.071 mm increase in left and a 0.077 mm increase in right bronchial transverse diameter (p < 0.001 for both). The RUL orifice showed posterior deviation of 15.5 ± 12.2° in men and 9.9 ± 11.4° in women, with height and weight being independent but weak predictors (R2 = 0.05). Bronchial diameter measurements showed consistent differences between 2D and 3D CT, with 2D images generally overestimating transverse diameters. Conclusions: The present analysis provides population-specific reference values for Korean adults. Our findings support the use of 2D CT as a practical tool for estimating bronchial dimensions and guiding DLT selection, and may serve as foundation for future airway devices tailored to Asian populations. Full article
(This article belongs to the Special Issue Advances in Perioperative Anesthesia: Emerging Techniques and Clinical Practices)
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