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Advances in the Clinical Management of Perioperative Anesthesia: 2nd Edition
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Advances in the Clinical Management of Perioperative Anesthesia: 2nd Edition

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

Deadline for manuscript submissions: 25 May 2026 | Viewed by 3315

Special Issue Editors

Dr. Alessia Mattei

E-Mail Website
Guest Editor
Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
Interests: anesthesia; pain management; perioperative medicine; anesthesiology; intensive care
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Rita Cataldo

E-Mail Website
Guest Editor
1. Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
2. Research Unit of Anaesthesia and Intensive Care, Department of Medicine and Surgery, Università Campus Bio Medico di Rome, Via Alvaro del Portillo, 21-00128 Rome, Italy
Interests: anesthesia; pain management; perioperative medicine; anesthesiology; intensive care; anesthesia in robotic surgery; ERAS; ERABS
Special Issues, Collections and Topics in MDPI journals
Dr. Alessandro Strumia

E-Mail
Guest Editor
Unit of Anaesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
Interests: anesthesia; pain management; perioperative medicine; cardiac anesthesia; regional anesthesia
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is our pleasure to invite you to contribute to this Special Issue entitled “Advances in the Clinical Management of Perioperative Anesthesia: 2nd Edition”. This is a new volume; more than seven papers were published in the first volume. For more details, please visit the following link: https://www.mdpi.com/journal/jcm/special_issues/DJ43E7QZ31.

Perioperative and anesthetic management undertaken for general surgery improves surgical outcomes. It requires close multidisciplinary collaboration between dedicated anesthetic, surgical, and clinical teams and should be based on a combination of multimodal evidence-based strategies applied to the conventional perioperative techniques, such as the Enhanced Recovery After Surgery (ERAS) protocols.

Preoperative evaluation with risk factor optimization, choice of anesthesia and anesthetic drugs, multimodal analgesia and pain management, fluid management, hemodynamic monitoring, postoperative early feeding, and early mobilization are key elements of a patient-centered strategy to reduce postoperative complications and achieve early recovery.

This Special Issue in the Journal of Clinical Medicine aims to publish topical clinical research related to the perioperative care of surgical patients, involving different areas of interest throughout the surgical pathway to recovery.

We welcome the submission of original research articles, narrative and/or systematic reviews, and meta-analyses focused on the clinical management of perioperative anesthesia.

Dr. Alessia Mattei
Prof. Dr. Rita Cataldo
Dr. Alessandro Strumia
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 outcomes (surgical, anesthetic, medical)
  • evidence-based care
  • perioperative guidelines and consensus statements
  • preoperative evaluation and risk scores
  • preoperative testing
  • surgical optimization and enhanced surgical recovery programs
  • intensive care unit

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

Published Papers (3 papers)

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12 pages, 783 KB  
Article
Single-Shot Subcutaneous Lidocaine Infiltration at Closure Is Associated with Reduced Early Pain and Opioid Requirement After Single-Incision Laparoscopic Totally Extraperitoneal Hernia Repair
by Jong Min Lee
J. Clin. Med. 2025, 14(23), 8324; https://doi.org/10.3390/jcm14238324 - 23 Nov 2025
Cited by 1 | Viewed by 725
Abstract
Background: Subcutaneous wound infiltration with local anesthetics has been proposed as a simple adjunct for postoperative pain control; however, its value in single-incision laparoscopic total extraperitoneal (SILTEP) inguinal hernia repair remains unclear. Methods: We retrospectively analyzed 199 consecutive SILTEP inguinal hernia repairs performed [...] Read more.
Background: Subcutaneous wound infiltration with local anesthetics has been proposed as a simple adjunct for postoperative pain control; however, its value in single-incision laparoscopic total extraperitoneal (SILTEP) inguinal hernia repair remains unclear. Methods: We retrospectively analyzed 199 consecutive SILTEP inguinal hernia repairs performed between November 2022 and July 2025 (117 no-lidocaine, 82 lidocaine). A double adjustment, combining 1:1 propensity score matching with multivariable regression across 20 multiply imputed datasets was performed. The primary outcome was maximal numeric pain intensity scale (NPIS) on postoperative day (POD) 0. Results: Eighty-two matched pairs were generated. In the final pooled, adjusted models, lidocaine infiltration was associated with a significant reduction in the primary outcome, maximal NPIS on POD 0 (β = −1.25; 95% CI: −2.01 to −0.50; p = 0.001). Lidocaine was also associated with significantly lower odds of requiring rescue analgesia on POD 0 (OR = 0.12; 95% CI: 0.03–0.46; p = 0.002), fewer rescue doses during hospitalization (β = −1.11; 95% CI: −1.62 to −0.49; p < 0.001), and a lower morphine-equivalent dose (β = −5.14; 95% CI: −7.79 to −2.49; p < 0.001). No increase in postoperative complications was observed. Conclusions: Single-shot subcutaneous lidocaine infiltration in SILTEP hernia repair is a simple, low-risk intervention that was associated with reduced immediate postoperative pain and opioid use without increasing complications. However, the effect was short-lived with no sustained benefit beyond the first postoperative day. Full article
(This article belongs to the Special Issue Advances in the Clinical Management of Perioperative Anesthesia: 2nd Edition)
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12 pages, 646 KB  
Case Report
Perioperative Anesthetic Considerations in HMG-CoA Lyase Deficiency: Case Report and Literature Review
by Vasileia Nyktari, Georgios Papastratigakis, Alexandra Koulousi, Chrysi Mandola, Foteini Chaniotaki, Ioannis Goniotakis, Stavroula Ilia and Alexandra Papaioannou
J. Clin. Med. 2025, 14(20), 7332; https://doi.org/10.3390/jcm14207332 - 17 Oct 2025
Viewed by 933
Abstract
Background/Objectives: 3-Hydroxy-3-methylglutaryl-CoA lyase deficiency (HMGCLD) is an extremely rare autosomal recessive metabolic disorder caused by mutations in the HMGCL gene. HMGCLD disrupts ketogenesis and β-oxidation, leading to energy failure during fasting or stress, with clinical episodes characterized by hypoglycemia, hyperammonemia, lactic acidosis, [...] Read more.
Background/Objectives: 3-Hydroxy-3-methylglutaryl-CoA lyase deficiency (HMGCLD) is an extremely rare autosomal recessive metabolic disorder caused by mutations in the HMGCL gene. HMGCLD disrupts ketogenesis and β-oxidation, leading to energy failure during fasting or stress, with clinical episodes characterized by hypoglycemia, hyperammonemia, lactic acidosis, and encephalopathy. Only 211 cases have been reported worldwide, with no prior reports on anesthetic management in these patients. Methods: We report a 14.5-year-old girl with known HMGCLD who was admitted with abdominal pain and nausea following a fatty meal. Imaging confirmed acute cholecystitis. Initial conservative management failed due to persistent vomiting and inability to tolerate feeding. Deviation from the metabolic protocol led to lactic acidosis and hypoglycemia, requiring intensive care with bicarbonate, carnitine, and glucose infusion. Once optimized, she underwent emergency laparoscopic cholecystectomy under sevoflurane-based anesthesia. Propofol was avoided, given the patient’s compromised lipid metabolism. Intraoperative glucose and acid-base status were closely monitored, with balanced dextrose-based fluids. Results: The patient remained hemodynamically stable throughout and was discharged three days postoperatively. Conclusions: This case highlights the anesthetic challenges of HMGCLD, where system-level miscommunication can trigger severe metabolic decompensation. A review of the literature emphasizes fasting avoidance, continuous glucose supplementation, careful drug and fluid selection, and multidisciplinary coordination. This report provides the first anesthetic roadmap for HMGCLD, underscoring the need for individualized care and meticulous perioperative metabolic control. Full article
(This article belongs to the Special Issue Advances in the Clinical Management of Perioperative Anesthesia: 2nd Edition)
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7 pages, 317 KB  
Case Report
Successful Cancer Surgery Without Transfusion Following Early Discontinuation of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention for Acute Myocardial Infarction
by Sungmin Suh, Nayoung Kim and Sangho Kim
J. Clin. Med. 2025, 14(18), 6456; https://doi.org/10.3390/jcm14186456 - 13 Sep 2025
Viewed by 825
Abstract
A 75-year-old Jehovah’s Witness with recent ST-elevation myocardial infarction (STEMI) underwent percutaneous coronary intervention (PCI) with stenting of the proximal LAD. She was later diagnosed with gallbladder cancer and required urgent surgery but firmly refused allogeneic blood transfusion. This posed a major challenge, [...] Read more.
A 75-year-old Jehovah’s Witness with recent ST-elevation myocardial infarction (STEMI) underwent percutaneous coronary intervention (PCI) with stenting of the proximal LAD. She was later diagnosed with gallbladder cancer and required urgent surgery but firmly refused allogeneic blood transfusion. This posed a major challenge, as the surgery was expected to cause significant bleeding, and the patient had undergone coronary stenting within the previous three months, which is when the risk of stent thrombosis is highest if dual antiplatelet therapy (DAPT) is interrupted. After conducting a careful multidisciplinary discussion and obtaining informed consent, both aspirin and clopidogrel were discontinued five days preoperatively. Through comprehensive blood conservation strategies—including acute normovolemic hemodilution (ANH), intraoperative cell salvage, and robotic-assisted minimally invasive surgery—the patient successfully underwent extended cholecystectomy without transfusion. This case highlights the possibility of safe, completely transfusion-free major surgery in patients with recent PCI and high thrombotic risk when individualized perioperative planning is applied. Full article
(This article belongs to the Special Issue Advances in the Clinical Management of Perioperative Anesthesia: 2nd Edition)
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