Integration of Smart Sensors in Perioperative Patient Safety Systems

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.