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JCM
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Perioperative Anesthesia: State of the Art and the Perspectives
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Perioperative Anesthesia: State of the Art and the Perspectives

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

Deadline for manuscript submissions: 20 September 2025 | Viewed by 3449

Special Issue Editor

Prof. Dr. Benedikt Preckel

E-Mail Website
Guest Editor
Department of Anesthesiology, Amsterdam University Centers, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
Interests: cardiovascular anesthesia; organ protection; perioperative diabetes treatment; patient safety; cognitive aids; sedation outside the operating room; simulation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

While perioperative and peri-procedural patients are becoming older with concomitantly more co-morbidities relevant for anesthesiological treatment, the safety of anesthesia has been constantly improved during the last few years, making it possible that even challenging cases can be handled safely with adequate outcome results. This is a combined result of advanced technical support with improved monitoring opportunities, new pharmacologic possibilities, optimized collaboration with other medical specialties, as well as improving teamwork in elective and emergency situation. This Special Issue of JCM will highlight challenges and solutions of the current state-of-the-art of perioperative care, from prehabilitation and pre-operative screening and risk evaluation to intraoperative treatment (different anesthetics, different modes of anesthesia, and different patient populations) and postoperative care in the postanesthesia care unit, the intensive care unit, as well as on the ward, but also after discharge from the hospital. The specialty is facing new challenges, e.g., workforce shortage, fatigue, and burn out among healthcare workers, but also global aspects like the impact of the healthcare system and anesthesia on the environment and sustainability. In this Special Issue, we welcome authors to submit papers on the current state-of-the-art of anesthesia treatment and future improvements to perioperative care throughout the whole care process.

Prof. Dr. Benedikt Preckel
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

  • preoperative risk evaluation
  • prehabilitation
  • hemodynamic monitoring
  • post-surgical monitoring
  • patient deterioration
  • human factors
  • non-technical skills
  • cognitive aids
  • anesthetic drugs
  • regional anesthesia
  • healthcare worker wellness

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Published Papers (3 papers)

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Research

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15 pages, 1139 KiB  
Article
Improved Perioperative Risk Education Through the Use of an Interactive Online Anaesthesia Education Tool (iPREDICT): A Prospective, Randomised Controlled Single-Centre Clinical Trial
by Heidi Ehrentraut, Alma Puskarevic, Andrea Kunsorg, Izdar Abulizi, Andreas Mayr, Milan Jung, Maximilian Schillings, Caroline Temme, Annika Pütz, Mark Coburn and Maria Wittmann
J. Clin. Med. 2025, 14(9), 3131; https://doi.org/10.3390/jcm14093131 - 30 Apr 2025
Viewed by 199
Abstract
Background/Objectives: Involving patients in the preoperative anaesthetic assessment (PAA) process can improve their understanding of risks and contribute to better postoperative recovery and outcomes. The iPREDICT study aims to investigate the feasibility of using an interactive consultation tool (ICT) to improve patient [...] Read more.
Background/Objectives: Involving patients in the preoperative anaesthetic assessment (PAA) process can improve their understanding of risks and contribute to better postoperative recovery and outcomes. The iPREDICT study aims to investigate the feasibility of using an interactive consultation tool (ICT) to improve patient awareness of anaesthesia-related risks. Methods: This prospective, single-centre, randomised, placebo-controlled clinical study included patients scheduled for elective surgery under general or combined general and regional anaesthesia. Participants were randomly assigned to online anaesthesia risk education in the ICT group (intervention) or a control group that watched a video without anaesthetic risk content. Both groups received a face-to-face PAA and were assessed about anaesthetic risk knowledge after PAA and two days later. Results: A total of 373 participants were randomised, and 315 completed the assigned online module prior to their PAA. The proportion of male participants was higher (>60%). Most participants already had prior anaesthesia experience. After PAA, 243 patients completed the first risk recall #1 questionnaire, with the ICT group identifying significantly more correct risks than the control group (median 13.0 vs. 11.0, p < 0.05). In risk recall #2, conducted two days after the PAA, knowledge retention remained stable in the control group, while the experimental group showed further improvement (median 14.0 vs. 13.0, p < 0.05). Conclusions: Using the ICT significantly improved patients’ knowledge of anaesthesia-related risks. These results suggest that interactive patient education tools are a feasible and effective way to improve patients’ understanding of perioperative anaesthesia risks, potentially contributing to better outcomes, which needs to be addressed in future projects. Full article
(This article belongs to the Special Issue Perioperative Anesthesia: State of the Art and the Perspectives)
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10 pages, 2186 KiB  
Article
A Comparative Analysis of the Impact of Two Different Cognitive Aid Bundle Designs on Adherence to Best Clinical Practice in Simulated Perioperative Emergencies
by Maartje van Haperen, Tom C. P. M. Kemper, Lena Koers, Suzanne B. E. van Wandelen, Elbert Waller, Eline S. de Klerk, Susanne Eberl, Markus W. Hollmann and Benedikt Preckel
J. Clin. Med. 2024, 13(17), 5253; https://doi.org/10.3390/jcm13175253 - 5 Sep 2024
Viewed by 995
Abstract
Background: Stress and human error during perioperative emergency situations can significantly impact patient morbidity and mortality. Previous research has shown that cognitive aid bundles (CABs) minimize critical misses by 75%. This study aimed to compare the effectiveness of two different CAB designs with [...] Read more.
Background: Stress and human error during perioperative emergency situations can significantly impact patient morbidity and mortality. Previous research has shown that cognitive aid bundles (CABs) minimize critical misses by 75%. This study aimed to compare the effectiveness of two different CAB designs with the same content in reducing missed critical management steps for simulated perioperative emergencies. Methods: A multicenter randomized controlled simulation-based study was conducted including 27 teams, each consisting of three participants; each team performed four simulation scenarios. In the first scenario for each team (Scenario 1), no CAB was used. Scenarios 2 and 3 were randomly allocated to the groups, with either a branched, clustered design (CAB-1) or a linear, step-by-step design (CAB-2) of the cognitive aid. In Scenario 4, the groups used one of the previously mentioned CABs according to their own preference. The primary outcome was the difference in the percentage of missed critical management steps between the two different CABs. Secondary outcomes included user preference for one CAB design and the reduction in percentage of missed critical management steps using any CAB versus no CAB. Results: Twenty-seven teams simulated 108 perioperative emergency situations. The percentage of missed critical management steps was similar between CAB-1 and CAB-2 (27% [interquartile range (IQR) 20–29] versus 29% [IQR 20–35], p = 0.23). However, most participants favored the branched, clustered design CAB-1 (77.8%). Additionally, employing any CAB reduced the percentage of missed critical management steps by 36% (33% missed steps vs. 21% missed steps, p = 0.003). Conclusions: While the two CAB designs did not differ significantly in reducing missed critical management steps, the branched, clustered design was perceived as more user-friendly. Importantly, using any CAB significantly reduced the percentage of missed critical management steps compared to not using a cognitive aid, emphasizing the need for CAB use in the operating room. Full article
(This article belongs to the Special Issue Perioperative Anesthesia: State of the Art and the Perspectives)
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Review

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12 pages, 758 KiB  
Review
Perioperative Anxiety: Current Status and Future Perspectives
by Corina Manuela Bello, Patryk Eisler and Thomas Heidegger
J. Clin. Med. 2025, 14(5), 1422; https://doi.org/10.3390/jcm14051422 - 20 Feb 2025
Viewed by 1862
Abstract
Perioperative anxiety is a multifaceted phenomenon that significantly impacts patients undergoing surgical procedures. Despite advancements in surgical techniques and anesthetic management, the psychological burden associated with anesthesia and surgery remains a significant challenge for healthcare providers. Up to 30% of patients suffer from [...] Read more.
Perioperative anxiety is a multifaceted phenomenon that significantly impacts patients undergoing surgical procedures. Despite advancements in surgical techniques and anesthetic management, the psychological burden associated with anesthesia and surgery remains a significant challenge for healthcare providers. Up to 30% of patients suffer from anesthesia-related preoperative anxiety, irrespective of whether the procedure is elective or emergent. Notably, anxiety can adversely affect patient outcomes, including pain management, patient safety, overall quality of care, and patient satisfaction. Addressing perioperative anxiety requires a comprehensive understanding of its causes, assessment tools, and management strategies to ensure optimal perioperative care. This review examines the historical context, incidence, causes, pathophysiology, assessment tools, and current evidence regarding management strategies for anesthesia-related anxiety, and provides an outlook on future directions for research and everyday practice. Full article
(This article belongs to the Special Issue Perioperative Anesthesia: State of the Art and the Perspectives)
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