Integration of Smart Sensors in Perioperative Patient Safety Systems
Keywords:
smart sensors, perioperative monitoring, patient safety, wearable technology, closed-loop anesthesiaAbstract
Miniaturized, wireless sensor technology has moved perioperative monitoring beyond the intermittent bedside check, and a growing body of clinical evidence now describes what continuous, sensor-driven surveillance can and cannot do for patient safety across the surgical episode. This review synthesizes recent evidence across four domains: continuous ward-based vital sign monitoring after surgery, sensor-based detection of opioid-induced respiratory depression, artificial-intelligence-augmented intraoperative and closed-loop anesthesia delivery, and radiofrequency-identification tracking of surgical instruments and sponges to prevent retained surgical items. Continuous monitoring reliably detects physiological deterioration and respiratory depression events that intermittent checks miss, with directionally consistent but still incompletely proven benefit for hard outcomes such as unplanned intensive care transfer and mortality. Intraoperative artificial-intelligence applications and RFID-based instrument tracking are technically mature but have been adopted unevenly, constrained less by device performance than by alarm burden, workflow integration, clinician trust, and reimbursement. We conclude that realizing the safety potential of perioperative smart sensors will depend as much on implementation science, standardized outcome definitions, and thoughtful alarm design as on further advances in sensor hardware itself.
References
Smart technologies and digital innovations for improving perioperative patient safety: a review (2025) Patient Safety in Surgery, PMID:41163177.
Davis, et al. (2025) Wearable Technology in Surgery: New Developments Toward Real-Time Patient Monitoring. ANZ Journal of Surgery, DOI:10.1111/ans.70275.
Postoperative use of fitness trackers for continuous monitoring of vital signs: a survey of hospitalized patients (2025) Journal of Clinical Monitoring and Computing, DOI:10.1007/s10877-025-01273-3.
Continuous vs Intermittent Postoperative Vital Sign Monitoring: A Cluster Randomized Crossover Trial. PMC, PMID:PMC13022735.
The impact of wearable continuous vital sign monitoring on deterioration detection and clinical outcomes in hospitalised patients: a systematic review and meta-analysis (2021) Critical Care, DOI:10.1186/s13054-021-03766-4.
Impact of wearable wireless continuous vital sign monitoring in abdominal surgical patients: before-after study (2024) BJS Open.
Wearable Continuous Vital Sign Monitoring Study (WARD-AMS) to Detect Clinical Deterioration in Postoperative General Surgery Patients: Protocol for a Randomized Controlled Trial (2025) JMIR Research Protocols, PMID:PMC12716825.
Impact of postoperative in-hospital continuous vital sign monitoring on healthcare costs, resource utilization and labor market outcomes. PMID:41941065.
Wearables and Improving Perioperative Patient Safety-Searching for Solutions! Anesthesia Patient Safety Foundation Newsletter.
Prediction of Opioid-Induced Respiratory Depression on Inpatient Wards Using Continuous Capnography and Oximetry: An International Prospective, Observational Trial (2020) PMID:32925318.
Continuous Pulse Oximetry and Capnography Monitoring for Postoperative Respiratory Depression and Adverse Events: A Systematic Review and Meta-analysis (2019) Anesthesia & Analgesia, DOI:10.1213/ANE.0000000000002557.
Role of continuous pulse oximetry and capnography monitoring in the prevention of postoperative respiratory failure, postoperative opioid-induced respiratory depression and adverse outcomes on hospital wards: A systematic review and meta-analysis (2024) Anaesthesia, Pain & Intensive Care.
Improving definitions and innovations for identification and prevention of postoperative opioid-induced respiratory depression (OIRD): Proceedings of the International Consensus Conference. PMC, PMID:PMC13278815.
Clinical evaluation of a wearable sensor for mobile monitoring of respiratory rate on hospital wards (2021) Journal of Clinical Monitoring and Computing, DOI:10.1007/s10877-021-00753-6.
Role of artificial intelligence in perioperative monitoring in anaesthesia. PMC, PMID:PMC10893801.
Transforming perioperative care: The current landscape and future trajectory of artificial intelligence in anesthesia-A narrative review (2026) PMID:42297385.
Artificial Intelligence in Anesthesia: Enhancing Precision, Safety, and Global Access Through Data-Driven Systems (2025) Journal of Clinical Medicine, DOI:10.3390/jcm14196900.
Machine Learning, Deep Learning, and Closed Loop Devices-Anesthesia Delivery. PMC, PMID:PMC9847584.
Closed-Loop Anesthesia: Advances in Automated Drug Delivery and Perioperative Monitoring. PMC, PMID:PMC12995145.
Advances in automated anesthesia: a comprehensive review (2024) Anesthesiology and Perioperative Science, DOI:10.1007/s44254-024-00085-z.
Remote Monitoring and Artificial Intelligence: Outlook for 2050. PMC, PMID:PMC10794024.
Retained Surgical Items (RSI): Building a Smarter Hospital with RFID. Jadak Technologies white paper.
ORLocate Surgical Counting and Detection System. STERIS Healthcare Knowledge Center.
Smart Tools: RFID Tracking for Surgical Instruments. Wyss Institute, Harvard University.
Retained surgical objects: preventable "never events" and the case for mandatory technology adoption. PMC, PMID:PMC12768046.
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Copyright (c) 2026 Katarzyna Girard, et al.

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