Editorial: Editors' showcase: perioperative medicine

Perioperative medicine has undergone a remarkable transformation over the past decades. Once primarily focused on ensuring safe anesthesia during surgery, the specialty has progressively expanded its scope to encompass the entire surgical journey, from preoperative risk assessment to postoperative recovery and long-term patient outcomes. Today's anesthesiologist is no longer simply responsible for guiding patients safely through the operating room; increasingly, the specialty is expected to optimize recovery, minimize complications, preserve functional capacity, and improve the overall patient experience.

This transformation has broadened both the responsibilities and the opportunities of perioperative physicians. Risk assessment begins long before the induction of anesthesia, while postoperative management increasingly extends beyond the post-anesthesia care unit to encompass rehabilitation, critical care, and the transition back to the community. Simultaneously, innovations such as artificial intelligence (AI), multimodal perioperative pathways, and greater patient and family engagement are reshaping the way care is delivered.

Although the articles gathered in this Research Topic address diverse clinical questions, they collectively illustrate this expanding vision of anesthesiology. Together, they demonstrate how the specialty is progressively moving beyond the operating room to improve outcomes across the entire perioperative continuum.

A defining feature of modern perioperative medicine is the recognition that patients respond differently to surgical stress. Beyond traditional demographic and clinical variables, physiological reserve and population-specific characteristics increasingly inform individualized perioperative care. In this Research Topic, exploratory work on submaximal cardiopulmonary exercise testing suggests that measures of cardiopulmonary reserve may improve the identification of patients at risk of intraoperative hemodynamic instability (Agarkov and Carr). Complementing this physiological approach, a veteran-centered analysis of postoperative nausea and vomiting highlights that established risk models may not perform equally across different populations, emphasizing the need for more tailored risk prediction (Schumacher et al.). Together, these studies illustrate the ongoing transition toward precision perioperative medicine.

Preventing complications before they occur has become a central objective of perioperative care. Two contributions focusing on postoperative nausea and vomiting and opioid-sparing analgesia illustrate the growing interest in multimodal care bundles combining optimized antiemetic prophylaxis, neuraxial techniques, and opioid reduction strategies (Williams et al.; Williams et al.). Although requiring further validation, these approaches reflect the broader philosophy of enhanced recovery pathways, where coordinated preventive interventions can collectively improve patient outcomes.

Optimal recovery depends on more than physiological optimization alone. The review on family engagement highlights the growing evidence that structured caregiver involvement can improve both clinical outcomes and patient experience (Assaf et al.). By promoting communication, education, and shared participation in care, this work reinforces the evolution toward truly patient- and family-centered perioperative medicine.

Perioperative care increasingly extends into the postoperative critical care period. The prospective study from Ghana demonstrates the high burden of intra-abdominal hypertension among critically ill patients and supports targeted surveillance in high-risk populations (Bandoh et al.). Beyond its specific findings, the study illustrates the importance of continuity of care across the perioperative pathway, from surgery to intensive care and recovery.

Finally, the collection looks toward the future by exploring the opportunities offered by AI in healthcare. A nationwide survey reveals generally positive attitudes among both physicians and patients, particularly when AI is viewed as supporting rather than replacing clinical judgment (Saasouh et al.). As digital technologies continue to evolve, successfully integrating innovation while preserving trust and the human dimensions of care will undoubtedly represent one of the defining challenges of the next era of perioperative medicine.

Collectively, these seven articles illustrate the expanding scope of modern perioperative medicine. The future of anesthesiology will be defined not only by safer anesthesia but also by its ability to anticipate risk, personalize care, and improve recovery across the entire surgical journey.

Generative AI statement

The author(s) declared that generative AI was not used in the creation of this manuscript.

Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Footnotes

Edited and Reviewed by: Tomohiko Aoe, Teikyo University Chiba Medical Center, Japan