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Life
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Advancements in Postoperative Management of Patients After Surgery
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Advancements in Postoperative Management of Patients After Surgery

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 3026

Special Issue Editors

Dr. Antonino Zanghi

E-Mail Website
Guest Editor
Department of Medical and Surgical Sciences and Advanced Technology G. F. Ingrassia, A.O.U. Policlinico “G. Rodolico–San Marco”—Catania, Via Santa Sofia, 87, 95123 Catania, Italy
Interests: surgery; robotics; pain management; general surgery
Dr. Luigi La Via

E-Mail Website
Guest Editor
Department of Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Policlinico “G.Rodolico-San Marco”, 95123 Catania, Italy
Interests: loco-regional anesthesia; pain medicine; ERAS
Special Issues, Collections and Topics in MDPI journals
Dr. Antonino Maniaci

E-Mail Website
Guest Editor
Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy
Interests: audiology; otology; artificial intelligence
Special Issues, Collections and Topics in MDPI journals
Dr. Alessandro Cappellani

E-Mail Website
Guest Editor
Department of Surgery, General Surgery and Breast Unit, University of Catania, Catania, Italy
Interests: general surgery; postoperative outcomes; microsurgery; robotics

Special Issue Information

Dear Colleagues,

This Special Issue aims to explore the latest advancements and best practices in postoperative management, focusing on improving patient outcomes, enhancing recovery, and optimizing care following surgical procedures. The collection of articles within this Special Issue offers a comprehensive overview of strategies, interventions, and innovations in postoperative care, with the ultimate goal of promoting patient well-being and reducing complications.

Key Themes and Topics:

  1. Enhanced Recovery After Surgery (ERAS) Protocols:
  • Implementing evidence-based perioperative care pathways to promote faster recovery and minimize complications.
  • Multimodal pain management approaches and reducing opioid usage.
  • Early mobilization, nutrition, and hydration optimization for improved patient outcomes.
  1. Postoperative Pain Management:
  • Novel approaches to pain assessments and individualized pain management plans.
  • The role of regional anesthesia and opioid-sparing techniques in postoperative pain control.
  1. Early Detection and Management of Complications:
  • Strategies for the early identification and management of common postoperative complications, such as surgical site infections, deep vein thrombosis, and respiratory complications.
  • Remote monitoring and telemedicine applications for postoperative follow-up and timely interventions.
  • Novel diagnostic tools and biomarkers for the early detection of complications.
  1. Rehabilitation and Functional Recovery:
  • Comprehensive rehabilitation programs to optimize physical and functional recovery after surgery.
  • Progressive exercise regimes, physical therapy, and occupational therapy interventions.
  • Assistive technologies and devices to improve mobility and independence.

This Special Issue highlights the importance of postoperative management in ensuring successful outcomes and patient satisfaction. By exploring innovative approaches, evidence-based protocols, and advancements in various aspects of postoperative care, this collection of articles offers valuable insights for healthcare professionals into optimizing patient recovery, reducing complications, and enhancing the overall quality of care. The knowledge gained from this Special Issue can pave the way for further advancements in postoperative management and contribute to improved patient experiences and outcomes.

Dr. Antonino Zanghi
Dr. Luigi La Via
Dr. Antonino Maniaci
Dr. Alessandro Cappellani
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. Life is an international peer-reviewed open access monthly 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

  • surgery
  • ERAS
  • postoperative management
  • recovery
  • pain

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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

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12 pages, 893 KiB  
Article
Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic Patients
by Yuh-Chyn Tsai, Shih-Feng Liu, Hui-Chuan Chang, Ching-Min Huang, Wan-Chun Hsieh, Chin-Ling Li, Ting-Lung Lin and Ho-Chang Kuo
Life 2025, 15(2), 312; https://doi.org/10.3390/life15020312 - 17 Feb 2025
Viewed by 454
Abstract
The use of high-flow nasal cannula (HFNC) as an oxygen therapy post-extubation has demonstrated varying success rates across different surgical populations. This study aimed to identify the predictive factors influencing HFNC weaning outcomes in patients with postoperative extubation hypoxemia. We conducted a retrospective [...] Read more.
The use of high-flow nasal cannula (HFNC) as an oxygen therapy post-extubation has demonstrated varying success rates across different surgical populations. This study aimed to identify the predictive factors influencing HFNC weaning outcomes in patients with postoperative extubation hypoxemia. We conducted a retrospective analysis of patients in a surgical intensive care unit, categorized into three major postoperative groups: cardiothoracic surgery, upper abdominal surgery, and other surgeries. Our analysis examined pre-extubation weaning profiles, vital signs before and after HFNC initiation, and changes in physiological parameters during HFNC use. A total of 90 patients were included, divided into two groups based on HFNC weaning success or failure. Key parameters analyzed included maximal inspiratory pressure (MIP), PaO2/FiO2 (P/F) ratio, vital signs, SpO2 levels, respiratory rate (RR), heart rate (HR), respiratory rate–oxygenation (ROX) index, and HFNC duration. The findings revealed that cardiothoracic and upper abdominal groups showed significantly higher HFNC weaning success rates (73.3% and 70.6%) compared to the other surgeries group (34.6%) (p = 0.004). Critical predictors of successful weaning included pre-HFNC SpO2, P/F ratio, and changes in the ROX index, particularly in upper abdominal and other surgeries groups. In cardiothoracic surgery patients, higher maximal inspiratory pressure (MIP) (p = 0.031) was associated with improved outcomes, while prolonged HFNC use correlated with weaning success in this group (p = 0.047). These findings underscore the necessity of tailoring HFNC strategies to surgical characteristics and individual patient profiles. For cardiothoracic surgery patients, pre-extubation MIP, post-extubation RR, ΔROX, and ΔHR were identified as key predictive factors. In upper abdominal surgery, pre-extubation P/F ratio, post-extubation SpO2, and ΔROX played crucial roles. For patients undergoing other types of surgeries, pre-extubation P/F ratio and ΔROX remained the most reliable predictors of HFNC weaning success. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
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9 pages, 361 KiB  
Article
Lower Levels of Vitamin D Are Associated with Higher Vasoactive–Inotropic Scores in Major Cardiac Surgery
by Adrian Stef, Constantin Bodolea, Simona Sorana Cainap, Monica Muntean, Aurelia Georgeta Solomonean, Nadina Tintiuc, Razvan Olimpiu Mada and Gabriel Cismaru
Life 2024, 14(11), 1349; https://doi.org/10.3390/life14111349 - 22 Oct 2024
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Abstract
Background: The vasoactive–inotropic score (VIS) predicts unfavorable outcomes after cardiac surgery in both children and adults. In our adult population, we investigated whether preoperative levels of vitamin D can predict the VIS and whether both vitamin D and the VIS can predict adverse [...] Read more.
Background: The vasoactive–inotropic score (VIS) predicts unfavorable outcomes after cardiac surgery in both children and adults. In our adult population, we investigated whether preoperative levels of vitamin D can predict the VIS and whether both vitamin D and the VIS can predict adverse outcomes following major heart surgery. Methods: Between 1 October 2021 and 28 February 2022, 300 patients underwent major cardiac surgery at our institution. Eighty-three of them had their 25-OH vitamin D levels measured before surgery. For this cohort, we calculated the VIS based on doses of vasoactive and inotropic medications administered post-surgery. Utilizing receiver operating curves, the predictive accuracy of vitamin D levels and the VIS in predicting acute kidney injury was assessed. Results: The median age of the cohort was 66 (IQR 61–71) years, with 59% being male and a median BMI of 28.4 (IQR 25.2–31.6). The most common procedures were aortic valve replacement, mitral valve replacement, coronary artery bypass grafting, aortic valve and ascending aorta repair, and ASD correction. There was a significant difference in the postoperative VIS between patients with vitamin D deficiency, i.e., <20 ng/mL, and patients with vitamin D values > 20 ng/mL (3.5 vs. 1.3 p < 0.04). We also found a significant correlation between the VIS and the days of hospitalization (r = 0.335; p = 0.002), the days of stay in the intensive care unit (r = 0.547; p < 0.00001), and the mechanical ventilation time (r = 0.327; p = 0.025). Both vitamin D levels and the VIS predicted postoperative acute kidney injury (p < 0.05). Conclusions: Vitamin D deficiency is correlated with the VIS in adults undergoing major cardiac surgery. Both vitamin D levels and the VIS can predict unfavorable postoperative outcomes. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
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Review

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20 pages, 1303 KiB  
Review
Neurological and Olfactory Disturbances After General Anesthesia
by Antonino Maniaci, Mario Lentini, Rosario Trombadore, Loris Gruppuso, Santo Milardi, Rosario Scrofani, Giuseppe Cuttone, Massimiliano Sorbello, Rodolfo Modica, Jerome R. Lechien, Paolo Boscolo-Rizzo, Daniele Salvatore Paternò and Luigi La Via
Life 2025, 15(3), 344; https://doi.org/10.3390/life15030344 - 22 Feb 2025
Viewed by 783
Abstract
Neurological and olfactory disturbances are increasingly recognized as potential complications of general anesthesia, particularly in vulnerable populations, such as the elderly, children, and individuals with comorbidities. Recent studies have highlighted the need for tailored anesthetic approaches in these high-risk groups to mitigate potential [...] Read more.
Neurological and olfactory disturbances are increasingly recognized as potential complications of general anesthesia, particularly in vulnerable populations, such as the elderly, children, and individuals with comorbidities. Recent studies have highlighted the need for tailored anesthetic approaches in these high-risk groups to mitigate potential long-term effects. These disturbances, including postoperative cognitive dysfunction, delirium, and olfactory deficits, often arise from shared pathophysiological mechanisms, such as neuroinflammation, oxidative stress, and disruptions in cerebral perfusion. The olfactory system is particularly susceptible to anesthesia-induced neurotoxicity given its proximity to central nervous system structures and its role in sensory and cognitive processing. Furthermore, the unique regenerative capacity of olfactory neurons may be compromised by prolonged or repeated exposure to anesthetic agents, potentially leading to long-term olfactory dysfunction. Risk factors, such as advanced age, neurodegenerative diseases, diabetes, cardiovascular conditions, genetic predispositions, and the type and duration of anesthesia exposure, further exacerbate these complications. Preventive strategies, including comprehensive preoperative risk assessment, personalized anesthetic protocols based on genetic and physiological profiles, and proactive postoperative care with early intervention programs, are critical for reducing impairments and improving long-term patient outcomes. Emerging evidence highlights the potential role of neuroprotective agents, such as antioxidants and anti-inflammatory therapies, in mitigating the effects of anesthesia-induced neurotoxicity. Longitudinal studies are needed to evaluate the long-term effects of anesthesia on cognitive and sensory health, particularly in high-risk populations. These studies should incorporate advanced neuroimaging techniques and biomarker analysis to elucidate the underlying mechanisms of anesthesia-induced neurological and olfactory disturbances. This narrative review provides a comprehensive overview of the mechanisms, risk factors, and preventive strategies for neurological and olfactory disturbances after general anesthesia and highlights future directions for research to improve patient outcomes. We conducted a comprehensive literature search using databases, such as PubMed and Scopus, to identify relevant studies. Full article
(This article belongs to the Special Issue Advancements in Postoperative Management of Patients After Surgery)
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