Molecular Mechanisms Driving Precision Medicine in Perioperative Care: Integrating Inflammation, Metabolism, and Neuroimmunomodulation for Personalized Outcomes.

Precision perioperative medicine connects mechanisms across inflammation, metabolism, and neuroimmunomodulation to predict risk and individualize therapy. This review aims to incorporate landmark concepts and recent studies (2017-2025) as well as outlining how multi-omics and clinical analytics translate biology into actionable pathways. Key opportunities include cytokine-guided risk stratification, metabolic conditioning, and autonomic neuromodulation targeting the cholinergic anti-inflammatory reflex. Implementation requires robust phenotyping, interoperable data pipelines, and trials focused on functional recovery and cognition.