The field of anesthesiology has been enriched by continual reinvention and innovation—first by eliminating surgical pain and awareness, then by dramatically reducing intraoperative mortality, and now by identifying and confronting the substantial risks that persist before and after surgery. Postoperative complications are the leading contributor to perioperative death, and the scope of anesthesia care has now expanded far beyond the operating room. Modern anesthesiology integrates neuroscience, physiology, engineering, and computational science to improve recovery, preserve cognition, and enhance long-term outcomes. Research remains the backbone of every major advance, enabling precise measurement, mechanistic insight, and innovation in patient care. With the addition of Anesthesiology Open, this editorial marks the launch of an expanded family of journals to showcase innovative advances. We reflect on the evolution of anesthesiology as a discipline and outline the next frontier taking shape in our field: transforming the entire perioperative trajectory rather than focusing solely on intraoperative care and safety. Anesthesiology and Anesthesiology Open together aim to cultivate the ideas and evidence that will define this next era, positioning anesthesiology at the forefront of medical progress.
Jiang et al. (2026) studied this question. Modern anesthesiology is expanding its focus beyond intraoperative safety to transform the entire perioperative trajectory and reduce postoperative complications.