JMIR Perioperative Medicine

Technology and data science for interdisciplinary innovation to improve care delivery and surgical patient outcomes.

Editor-in-Chief:

Nidhi Rohatgi, MD, MS, SFHM, Clinical Professor of Medicine and (by courtesy) Neurosurgery, Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, USA


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JMIR Perioperative Medicine is a global, peer-reviewed, open access journal indexed in PubMed, PubMed CentralDirectory of Open Access Journals (DOAJ Seal), SCOPUS, EBSCO/EBSCO Essentials and Sherpa/Romeo.

We welcome contributions from diverse specialties impacting the care of surgical patients, such as, surgery, anesthesiology, general medicine, physiatry, nursing, allied health professionals, experts in artificial intelligence (AI), digital health technology, and also from informaticians, scientists, clinical trialists, health service researchers, quality improvement champions, or subspecialists (e.g., cardiologists, hematologists, pulmonologists) involved in Perioperative Medicine research. 

We accept original research, reviews (literature reviews and app/technology/wearable review), viewpoints, tutorials, research letters, quality improvement studies and observational studies.

JMIR Perioperative Medicine adheres to rigorous quality standards, involving a rapid and thorough peer-review process, professional copyediting, and professional production of PDF, XHTML, and XML proofs.

Recent Articles

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Theme Issue 2024: Perioperative Blood Management

The journey of receiving blood as a patient with transfusion-dependent beta thalassemia has profoundly shaped my understanding of the life-saving power of blood donation. This personal experience underscores the critical importance of blood donors, not just for individual recipients but for the broader community, enhancing public health, productivity, and well-being. There are several challenges to securing a blood donor pool in current health care climate. Solutions that focus on the engagement of donors, clinicians, and patients are key to improving the donor pool and utilizing the blood supply in a judicious manner.

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Outcomes Research in Perioperative Medicine

Biofeedback-based virtual reality (VR-BF) is a novel, nonpharmacologic method for teaching patients how to control their breathing, which in turn increases heart rate variability (HRV) and may reduce pain. Unlike traditional forms of biofeedback, VR-BF is delivered through a gamified virtual reality environment, increasing the accessibility of biofeedback. This is the first study to systematically integrate VR-BF use in the pediatric perioperative setting, with the ultimate goal of evaluating the efficacy of VR-BF to reduce pain, anxiety, and opioid consumption once feasibility and acceptability have been established.

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Perioperative Risk Assessment

Preoperative cardiac risk assessment is an integral part of preoperative evaluation; however, there is significant variation among providers, leading to inappropriate referrals for cardiology consultation or excessive low-value cardiac testing. We implemented a novel electronic medical record (EMR) form in our preoperative clinics to decrease variation.

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Postoperative Monitoring and Telemonitoring

Digital technology and gamified apps can be useful in the health care context. Gamification uses technology to influence users’ actions and motivations through experiences that resemble games. Patient adherence to the enhanced recovery after surgery (ERAS) program is crucial for achieving early recovery after surgery and continuous monitoring is essential for obtaining good results.

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Perioperative Patient Education

The preadmission clinic (PAC) is crucial in perioperative care, offering evaluations, education, and patient optimization before surgical procedures. During the COVID-19 pandemic, the PAC adapted by implementing telephone visits due to a lack of infrastructure for video consultations. While the pandemic significantly increased the use of virtual care, including video appointments as an alternative to in-person consultations, our PAC had not used video consultations for preoperative assessments.

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Patient Monitoring and Anesthesia Information Management Systems

Neuromuscular blockade (NMB) agents are a critical component of balanced anesthesia. NMB reversal methods can include spontaneous reversal, sugammadex, or neostigmine and the choice of reversal strategy can depend on various factors. Unanticipated changes to clinical practice emerged due to the COVID-19 pandemic, and a better understanding of how NMB reversal trends were affected by the pandemic may help provide insight into how providers view the tradeoffs in the choice of NMB reversal agents.

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Perioperative Risk Assessment

Exposure to opioids after surgery is the initial contact for some people who develop chronic opioid use disorder. Hence, effective postoperative pain management, with less reliance on opioids, is critical. The Perioperative Opioid Quality Improvement (POQI) program developed (1) a digital health platform leveraging patient-survey-reported risk factors and (2) a postsurgical pain risk stratification algorithm to personalize perioperative care by integrating several commercially available digital health solutions into a combined platform. Development was reduced in scope by the COVID-19 pandemic.

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Patient Education for Surgery and Anesthesiology

As of 2022, patient adherence to postoperative guidelines can reduce the risk of complications by up to 52.4% following laparoscopic abdominal surgery. With the availability of various preoperative education interventions (POEIs), understanding which POEI results in improvement in patient outcomes across the procedures is imperative.

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Mobile tools for surgery and perioperative medicine

Pip is a novel digital health platform (DHP) that combines human health coaches (HCs) and technology with patient-facing content. This combination has not been studied in perioperative surgical optimization.

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Viewpoints

The purpose of this viewpoint is to provide awareness of the current opportunities to enhance a high-value care approach to blood product transfusion. It provides a historical context to the evolution of blood management, as well as of the patient safety and high-value care movement. Leveraging current technology for enhanced education, as well as clinical decision support, is also discussed.

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Patient Monitoring and Anesthesia Information Management Systems

Osteoarthritis is a significant cause of disability, resulting in increased joint replacement surgeries and health care costs. Establishing benchmarks that more accurately predict surgical duration could help to decrease costs, maximize efficiency, and improve patient experience. We compared the anesthesia-controlled time (ACT) and surgery-controlled time (SCT) of primary total knee (TKA) and total hip arthroplasties (THA) between an academic medical center (AMC) and a community hospital (CH) for 2 orthopedic surgeons.

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Qualitative Studies, Thematic Studies, Surveys in Perioperative Medicine

Major surgery on patients with anemia has demonstrated an increased risk of perioperative blood transfusions and postoperative morbidity and mortality. Recent studies have shown that integrating preoperative anemia treatment as a component of perioperative blood management may reduce blood product utilization and improve outcomes in both cardiac and noncardiac surgery. However, outpatient management of anemia falls outside of daily practice for most anesthesiologists and is probably weakly understood.

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