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Advances in Anesthesia and Intensive Care During Perioperative Period
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Advances in Anesthesia and Intensive Care During Perioperative Period

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

Deadline for manuscript submissions: 30 October 2025 | Viewed by 619

Special Issue Editor

Prof. Dr. Philipp Simon

E-Mail Website
Guest Editor
Anesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany
Interests: postoperative outcome; anesthesia; cardiac anesthesia; severe hypoxemic respiratory failure; critical care medicine; intensive care medicine; post intensive care syndrome; sepsis; infection; mechanical ventilation; airway management; resuscitation; CPR; emergency management; pain management; big data; machine learning; AI
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Knowledge management in anesthesia, intensive care, and emergency medicine has seen a considerable boost in the last 15 years, partly due to the introduction of automated measurement data transfer to electronic protocols and patient records. On the one hand, this offers an enormous opportunity to make predictions based on corresponding analyses that were previously not easily accessible due to their complexity. One example of this is telemetric applications in intensive care and emergency medicine. The benefits of AI-supported technologies are also being demonstrated in practice in the field of ultrasound technology in regional anesthesia and closed-loop anesthesia systems. In addition, various fast-track concepts are becoming increasingly important in perioperative medicine. This progress should be seen as a great opportunity in anesthesiology and intensive care medicine, as it enables practitioners to make decisions in less time and adapt to treatment more quickly by recognizing changes faster. Digitalization is paving the way for further specification and more patient-orientated individual therapy decisions (ventilation, medication, etc.) based on patient-specific data, both in the operating theatre and in intensive care medicine.

Manuscripts can be submitted in the form of original studies, meta-analysis, or reviews.

Prof. Dr. Philipp Simon
Guest Editor

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

  • general anesthesia
  • intensive care medicine
  • post intensive care syndrome
  • perioperative management
  • fast track
  • pain management
  • complications
  • postoperative outcome
  • digitalization
  • big data
  • AI
  • closed-loop systems
  • machine learning
  • clinical decision support
  • telemedicine

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Published Papers (2 papers)

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Research

15 pages, 698 KiB  
Article
Systemic Lidocaine Infusion for Acute Pain Management in a Surgical Intensive Care Unit: A Single-Arm Pilot Trial
by Hina Faisal, Faisal N. Masud, Mahmoud M. Sabawi, Nghi (Andy) Bui, Sara A. Butt and George E. Taffet
J. Clin. Med. 2025, 14(13), 4390; https://doi.org/10.3390/jcm14134390 - 20 Jun 2025
Abstract
Objectives: Currently, there are a lack of data on the use of systemic lidocaine infusion in critically ill surgical patients, particularly regarding optimal dosing and monitoring. This study aimed to assess the feasibility of conducting a subsequent full-scale, randomized controlled trial (RCT) [...] Read more.
Objectives: Currently, there are a lack of data on the use of systemic lidocaine infusion in critically ill surgical patients, particularly regarding optimal dosing and monitoring. This study aimed to assess the feasibility of conducting a subsequent full-scale, randomized controlled trial (RCT) on the use of systemic lidocaine infusion in surgical intensive care units (ICUs). Methods: A single-center, prospective, single-arm pilot trial was conducted at the surgical intensive care unit (ICU) at Houston Methodist Hospital. The study population included 12 subjects over 18 years old who were admitted to the surgical ICU after open abdominal surgery. A low-dose lidocaine infusion of 10–30 mcg/kg/min within 1 h of ICU admission. Results: The feasibility outcomes encompassed recruitment, retention, and withdrawal rates. The study initially screened 18 participants, all of whom were successfully enrolled, resulting in a recruitment rate of 100%. However, 6 participants (33.3%) from the enrolled group were subsequently withdrawn for various reasons, resulting in a retention rate of 12 participants (66.7%). All 12 remaining participants were included in the analysis at the baseline stage. The safety outcomes included adverse events and serum lidocaine levels, with no serious adverse events reported. Dizziness and hypertension were the most frequently reported adverse events in their respective categories, affecting 16.7% of patients each. Four patients (33%) exhibited elevated lidocaine levels exceeding 5 mcg/mL; however, no clinical features of lidocaine toxicity were observed. This study adhered to the CONSORT 2010 extension for pilot and feasibility trials. In accordance with these guidelines, no formal hypothesis testing for efficacy was performed. The exploratory outcomes included a reduction in opioid requirements, as measured by morphine milligram equivalents (MMEs), and pain scores. The median MMEs decreased from 22.6 on postoperative day 0 to 2.5 on day 3. The pain scores decreased by 1.09 units per day (β = −1.09; 95% CI: −1.82 to −0.36; p = 0.003); however, the absence of a control group limits the robustness of this observation. Conclusions: A large-scale, randomized controlled trial to evaluate the safety and efficacy of systemic lidocaine infusion in the surgical intensive care unit (ICU) seems feasible, with minor adjustments to the eligibility criteria and improved collaboration among nurses, anesthesiologists, and surgeons. Full article
(This article belongs to the Special Issue Advances in Anesthesia and Intensive Care During Perioperative Period)
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14 pages, 468 KiB  
Article
Postoperative Surveillance in the Postoperative vs. Intensive Care Unit for Patients Undergoing Elective Supratentorial Brain Tumor Removal: A Retrospective Observational Study
by Stefanie Nothofer, Julia Geipel, Kathrin Aehling, Björn Sommer, Axel Rüdiger Heller, Ehab Shiban and Philipp Simon
J. Clin. Med. 2025, 14(8), 2632; https://doi.org/10.3390/jcm14082632 - 11 Apr 2025
Viewed by 436
Abstract
Background: Recent evidence suggests that alternative postoperative surveillance approaches for patients undergoing elective neurosurgical procedures are less resource-intensive and result in similar or fewer complications compared to high-care settings such as Intensive Care Units (ICUs). A new postoperative care protocol was established [...] Read more.
Background: Recent evidence suggests that alternative postoperative surveillance approaches for patients undergoing elective neurosurgical procedures are less resource-intensive and result in similar or fewer complications compared to high-care settings such as Intensive Care Units (ICUs). A new postoperative care protocol was established at our facility including routine PACU admission and predefined criteria for ICU admission. We aimed to demonstrate that PACU admission is a safe option for patients undergoing elective craniotomy following eventless surgery. Methods: This retrospective analysis included patients undergoing elective supratentorial craniotomy before and after the implementation of the new protocol. Patients with surgery between January 2020 and January 2022 and routine ICU admission were compared to patients undergoing surgery between February 2022 and March 2023 with either PACU or ICU admission based on the new protocol regarding lengths of hospital stay (LOSs), costs, and complications. Results: Data from a total of 405 patients, 198 patients before and 209 patients after the protocol implementation, were included. Both groups were comparable regarding demographics, American Society of Anesthesiologists (ASA) physical status classification, preexisting health conditions, and tumor entity and volume. Postoperative LOSs were significantly shorter in PACU compared to ICU patients of the same cohort (6 d vs. 11 d, p = 0.002). Patients with postoperative PACU transfer suffered fewer intracranial infections, surgical site infections, and pneumonia occurrences. Surgery-related complications, 30- and 90-day readmissions, and mortality rates were comparable in both groups. Conclusions: Postoperative PACU admission is a safe and viable option for patients undergoing elective craniotomy when selection is thorough and is associated with fewer ICU-related complications. Full article
(This article belongs to the Special Issue Advances in Anesthesia and Intensive Care During Perioperative Period)
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