Anesthesia management for thoracoscopic lung cancer surgery under the concept of enhanced recovery after surgery_West China Medical Journal

Authors：

ZHAO Haishi , FENG Yan ,  SUN Defeng

Department of Anesthesiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P. R. China;

Corresponding author：

SUN Defeng, Email: sdf-yl@163.com

Keywords：

Anesthesia; enhanced recovery after surgery; thoracoscopic lung cancer surgery

DOI：

10.7507/1002-0179.202406052

Video：

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Since the proposal of enhanced recovery after surgery (ERAS), significant progress has been made in different surgical fields, but ERAS in thoracic surgery is still in its infancy. This article summarizes the research results of scholars at home and abroad, and provides a comprehensive overview of the ERAS anesthesia management pathway during the perioperative period of thoracic surgery from the aspects of preoperative evaluation, anesthesia scheme selection, ventilation strategy, fluid management, temperature protection, pain management, postoperative nausea and vomiting, and early mobilization. The aim is to provide a reference for ERAS management in thoracoscopic lung cancer surgery.

Citation： ZHAO Haishi, FENG Yan, SUN Defeng. Anesthesia management for thoracoscopic lung cancer surgery under the concept of enhanced recovery after surgery. West China Medical Journal, 2025, 40(1): 136-141. doi: 10.7507/1002-0179.202406052 Copy

1.	郑荣寿, 陈茹, 韩冰峰, 等. 2022 年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2024, 46(3): 221-231.
2.	Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
3.	Das-Neves-Pereira JC, Bagan P, Coimbra-Israel AP, et al. Fast-track rehabilitation for lung cancer lobectomy: a five-year experience. Eur J Cardiothorac Surg, 2009, 36(2): 383-392.
4.	Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS^®) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg, 2019, 55(1): 91-115.
5.	郑娥, 沈诚, 王维, 等. 加速康复外科在中国大陆各区域医院胸外科的应用现状分析. 中国胸心血管外科临床杂志, 2018, 25(8): 681-686.
6.	Nakahara K, Monden Y, Ohno K, et al. A method for predicting postoperative lung function and its relation to postoperative complications in patients with lung cancer. Ann Thorac Surg, 1985, 39(3): 260-265.
7.	Kang HJ, Lee SS. Comparison of predicted postoperative lung function in pneumonectomy using computed tomography and lung perfusion scans. J Chest Surg, 2021, 54(6): 487-493.
8.	Gould MK, Donington J, Lynch WR, et al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(Suppl 5): e93S-e120S.
9.	Daniel M, Lang E, Huynh TM, et al. Prevalence and time-course of diaphragmatic dysfunction following lung resection: a repeated ultrasonic assessment. Anaesth Crit Care Pain Med, 2022, 41(2): 101024.
10.	Ramos R, Nadal E, Peiró I, et al. Preoperative nutritional status assessment predicts postoperative outcomes in patients with surgically resected non-small cell lung cancer. Eur J Surg Oncol, 2018, 44(9): 1419-1424.
11.	Matsuoka K, Yamada T, Matsuoka T, et al. Significance of body mass index for postoperative outcomes after lung cancer surgery in elderly patients. World J Surg, 2018, 42(1): 153-160.
12.	中国抗癌协会肿瘤营养专业委员会, 中华医学会肠外肠内营养学分会. 肺癌患者的营养治疗专家共识. 肿瘤代谢与营养电子杂志, 2023, 10(3): 336-341.
13.	Kadomatsu Y, Sugiyama T, Sato K, et al. Relationship of smoking cessation period with the incidence of complications in lung cancer surgery. Eur J Cardiothorac Surg, 2022, 62(3): ezac163.
14.	Heiden BT, Eaton DB Jr, Chang SH, et al. Assessment of duration of smoking cessation prior to surgical treatment of non-small cell lung cancer. Ann Surg, 2023, 277(4): e933-e940.
15.	Pierre S, Rivera C, Le Maître B, et al. Guidelines on smoking management during the perioperative period. Anaesth Crit Care Pain Med, 2017, 36(3): 195-200.
16.	Argudo N, Rodó-Pin A, Martínez-Llorens J, et al. Feasibility, tolerability, and effects of exercise-based prehabilitation after neoadjuvant therapy in esophagogastric cancer patients undergoing surgery: an interventional pilot study. Dis Esophagus, 2021, 34(4): doaa086.
17.	Pu CY, Batarseh H, Zafron ML, et al. Effects of preoperative breathing exercise on postoperative outcomes for patients with lung cancer undergoing curative intent lung resection: a meta-analysis. Arch Phys Med Rehabil, 2021, 102(12): 2416-2427. e4.
18.	Yilmaz M, Çelik M. The effects of preoperative fasting on patients undergoing thoracic surgery. J Perianesth Nurs, 2021, 36(2): 167-173.
19.	Gillis C, Ljungqvist O, Carli F. Prehabilitation, enhanced recovery after surgery, or both? A narrative review. Br J Anaesth, 2022, 128(3): 434-448.
20.	Joshi GP, Abdelmalak BB, Weigel WA, et al. Domino KB. 2023 American Society of Anesthesiologists practice guidelines for preoperative fasting: carbohydrate-containing clear liquids with or without protein, chewing gum, and pediatric fasting duration-a modular update of the 2017 American Society of Anesthesiologists practice guidelines for preoperative fasting. Anesthesiology, 2023, 138(2): 132-151.
21.	Gaulton TG, Wunsch H, Gaskins LJ, et al. Preoperative sedative-hypnotic medication use and adverse postoperative outcomes. Ann Surg, 2021, 274(2): e108-e114.
22.	Qiu G, Wang P, Rao J, et al. Dexmedetomidine inhibits paraventricular corticotropin-releasing hormone neurons that attenuate acute stress-induced anxiety-like behavior in mice. Anesthesiology, 2024, 140(6): 1134-1152.
23.	Li C, Tao M, Chen D, et al. Transcranial direct current stimulation for anxiety during laparoscopic colorectal cancer surgery: a randomized clinical trial. JAMA Netw Open, 2024, 7(4): e246589.
24.	Crabtree TD, Puri V, Bell JM, et al. Outcomes and perception of lung surgery with implementation of a patient video education module: a prospective cohort study. J Am Coll Surg, 2012, 214(5): 816-821.e2.
25.	Chappell D, Heindl B, Jacob M, et al. Sevoflurane reduces leukocyte and platelet adhesion after ischemia-reperfusion by protecting the endothelial glycocalyx. Anesthesiology, 2011, 115(3): 483-491.
26.	Pang QY, An R, Liu HL. Effects of inhalation and intravenous anesthesia on intraoperative cardiopulmonary function and postoperative complications in patients undergoing thoracic surgery. Minerva Anestesiol, 2018, 84(11): 1287-1297.
27.	Liu J, Liang H, Cui F, et al. Spontaneous versus mechanical ventilation during video-assisted thoracoscopic surgery for spontaneous pneumothorax: a randomized trial. J Thorac Cardiovasc Surg, 2022, 163(5): 1702-1714.e7.
28.	Rosboch GL, Lyberis P, Ceraolo E, et al. The anesthesiologist’s perspective regarding non-intubated thoracic surgery: a scoping review. Front Surg, 2022, 9: 868287.
29.	Huang C, Huang Q, Shen Y, et al. General anaesthesia with double-lumen intubation compared to opioid-sparing strategies with laryngeal mask for thoracoscopic surgery: a randomised trial. Anaesth Crit Care Pain Med, 2022, 41(3): 101083.
30.	Chen KC, Cheng YJ, Hung MH, et al. Nonintubated thoracoscopic lung resection: a 3-year experience with 285 cases in a single institution. J Thorac Dis, 2012, 4(4): 347-351.
31.	Moreault O, Couture EJ, Provencher S, et al. Double-lumen endotracheal tubes and bronchial blockers exhibit similar lung collapse physiology during lung isolation. Can J Anaesth, 2021, 68(6): 791-800.
32.	Somma J, Couture ÉJ, Pelletier S, et al. Non-ventilated lung deflation during one-lung ventilation with a double-lumen endotracheal tube: a randomized-controlled trial of occluding the non-ventilated endobronchial lumen before pleural opening. Can J Anaesth, 2021, 68(6): 801-811.
33.	Brassard CL, Lohser J, Donati F, et al. Step-by-step clinical management of one-lung ventilation: continuing professional development. Can J Anaesth, 2014, 61(12): 1103-1121.
34.	Joe YE, Lee CY, Kim N, et al. Effect of permissive hypercarbia on lung oxygenation during one-lung ventilation and postoperative pulmonary complications in patients undergoing thoracic surgery: a prospective randomised controlled trial. Eur J Anaesthesiol, 2023, 40(9): 691-698.
35.	Blank RS, Colquhoun DA, Durieux ME, et al. Management of one-lung ventilation: impact of tidal volume on complications after thoracic surgery. Anesthesiology, 2016, 124(6): 1286-1295.
36.	Ferrando C, Carramiñana A, Piñeiro P, et al. Individualised, perioperative open-lung ventilation strategy during one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled clinical trial. Lancet Respir Med, 2024, 12(3): 195-206.
37.	Shum S, Huang A, Slinger P. Hypoxaemia during one lung ventilation. BJA Educ, 2023, 23(9): 328-336.
38.	Wu XZ, Xia HM, Zhang P, et al. Effects of ultrasound-guided alveolar recruitment manoeuvres compared with sustained inflation or no recruitment manoeuvres on atelectasis in laparoscopic gynaecological surgery as assessed by ultrasonography: a randomized clinical trial. BMC Anesthesiol, 2022, 22(1): 261.
39.	Baar W, Semmelmann A, Knoerlein J, et al. Risk factors for postoperative pulmonary complications leading to increased in-hospital mortality in patients undergoing thoracotomy for primary lung cancer resection: a multicentre retrospective cohort study of the German Thorax Registry. J Clin Med, 2022, 11(19): 5774.
40.	Matot I, Dery E, Bulgov Y, et al. Fluid management during video-assisted thoracoscopic surgery for lung resection: a randomized, controlled trial of effects on urinary output and postoperative renal function. J Thorac Cardiovasc Surg, 2013, 146(2): 461-466.
41.	Zhang J, Chen CQ, Lei XZ, et al. Goal-directed fluid optimization based on stroke volume variation and cardiac index during one-lung ventilation in patients undergoing thoracoscopy lobectomy operations: a pilot study. Clinics (Sao Paulo), 2013, 68(7): 1065-1070.
42.	Li Y, Liang H, Feng Y. Prevalence and multivariable factors associated with inadvertent intraoperative hypothermia in video-assisted thoracoscopic surgery: a single-center retrospective study. BMC Anesthesiol, 2020, 20(1): 25.
43.	Sessler DI, Pei L, Li K, et al. Aggressive intraoperative warming versus routine thermal management during non-cardiac surgery (PROTECT): a multicentre, parallel group, superiority trial. Lancet, 2022, 399(10337): 1799-1808.
44.	Min SH, Yoon S, Yoon SH, et al. Randomised trial comparing forced-air warming to the upper or lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position. Br J Anaesth, 2018, 120(3): 555-562.
45.	Liu Y, Xiao S, Yang H, et al. Postoperative pain-related outcomes and perioperative pain management in China: a population-based study. Lancet Reg Health West Pac, 2023, 39: 100822.
46.	Cohen JB, Smith BB, Teeter EG. Update on guidelines and recommendations for enhanced recovery after thoracic surgery. Curr Opin Anaesthesiol, 2024, 37(1): 58-63.
47.	Kweon DE, Koo Y, Lee S, et al. Postoperative infusion of a low dose of dexmedetomidine reduces intravenous consumption of sufentanil in patient-controlled analgesia. Korean J Anesthesiol, 2018, 71(3): 226-231.
48.	Feray S, Lubach J, Joshi GP, et al. PROSPECT guidelines for video-assisted thoracoscopic surgery: a systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia, 2022, 77(3): 311-325.
49.	Maxwell C, Nicoara A. New developments in the treatment of acute pain after thoracic surgery. Curr Opin Anaesthesiol, 2014, 27(1): 6-11.
50.	Fang B, Wang Z, Huang X. Ultrasound-guided preoperative single-dose erector spinae plane block provides comparable analgesia to thoracic paravertebral block following thoracotomy: a single center randomized controlled double-blind study. Ann Transl Med, 2019, 7(8): 174.
51.	Elsabeeny WY, Ibrahim MA, Shehab NN, et al. Serratus anterior plane block and erector spinae plane block versus thoracic epidural analgesia for perioperative thoracotomy pain control: a randomized controlled study. J Cardiothorac Vasc Anesth, 2021, 35(10): 2928-2936.
52.	Gan TJ, Diemunsch P, Habib AS, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 2014, 118(1): 85-113.
53.	Feng CD, Xu Y, Chen S, et al. Opioid-free anaesthesia reduces postoperative nausea and vomiting after thoracoscopic lung resection: a randomised controlled trial. Br J Anaesth, 2024, 132(2): 267-276.
54.	Kuroda H, Sugita Y, Watanabe K, et al. Successful postoperative recovery management after thoracoscopic lobectomy and segmentectomy using an ERAS-based protocol of immediate ice cream intake and early ambulation: a 3-year study. Cancer Manag Res, 2019, 11: 4201-4207.
55.	Yang F, Li L, Mi Y, et al. Effectiveness of the tailored, early comprehensive rehabilitation program (t-ECRP) based on ERAS in improving the physical function recovery for patients following minimally invasive esophagectomy: a prospective randomized controlled trial. Support Care Cancer, 2022, 30(6): 5027-5036.
56.	Chen K, Yu S, Zhang Z, et al. Investigation and analysis of influencing factors of early activity compliance of patients after minimally invasive esophagectomy. Ann Palliat Med, 2021, 10(12): 12657-12663.
57.	Okur E, Baysungur V, Tezel C, et al. Comparison of the single or double chest tube applications after pulmonary lobectomies. Eur J Cardiothorac Surg, 2009, 35(1): 32-36.
58.	Refai M, Brunelli A, Salati M, et al. The impact of chest tube removal on pain and pulmonary function after pulmonary resection. Eur J Cardiothorac Surg, 2012, 41(4): 820-823.
59.	高尊正, 冯艳, 孙德峰. 加速康复外科理念下的日间手术麻醉管理. 华西医学, 2023, 38(2): 170-179.

1. 郑荣寿, 陈茹, 韩冰峰, 等. 2022 年中国恶性肿瘤流行情况分析. 中华肿瘤杂志, 2024, 46(3): 221-231.
2. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
3. Das-Neves-Pereira JC, Bagan P, Coimbra-Israel AP, et al. Fast-track rehabilitation for lung cancer lobectomy: a five-year experience. Eur J Cardiothorac Surg, 2009, 36(2): 383-392.
4. Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS^®) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg, 2019, 55(1): 91-115.
5. 郑娥, 沈诚, 王维, 等. 加速康复外科在中国大陆各区域医院胸外科的应用现状分析. 中国胸心血管外科临床杂志, 2018, 25(8): 681-686.
6. Nakahara K, Monden Y, Ohno K, et al. A method for predicting postoperative lung function and its relation to postoperative complications in patients with lung cancer. Ann Thorac Surg, 1985, 39(3): 260-265.
7. Kang HJ, Lee SS. Comparison of predicted postoperative lung function in pneumonectomy using computed tomography and lung perfusion scans. J Chest Surg, 2021, 54(6): 487-493.
8. Gould MK, Donington J, Lynch WR, et al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(Suppl 5): e93S-e120S.
9. Daniel M, Lang E, Huynh TM, et al. Prevalence and time-course of diaphragmatic dysfunction following lung resection: a repeated ultrasonic assessment. Anaesth Crit Care Pain Med, 2022, 41(2): 101024.
10. Ramos R, Nadal E, Peiró I, et al. Preoperative nutritional status assessment predicts postoperative outcomes in patients with surgically resected non-small cell lung cancer. Eur J Surg Oncol, 2018, 44(9): 1419-1424.
11. Matsuoka K, Yamada T, Matsuoka T, et al. Significance of body mass index for postoperative outcomes after lung cancer surgery in elderly patients. World J Surg, 2018, 42(1): 153-160.
12. 中国抗癌协会肿瘤营养专业委员会, 中华医学会肠外肠内营养学分会. 肺癌患者的营养治疗专家共识. 肿瘤代谢与营养电子杂志, 2023, 10(3): 336-341.
13. Kadomatsu Y, Sugiyama T, Sato K, et al. Relationship of smoking cessation period with the incidence of complications in lung cancer surgery. Eur J Cardiothorac Surg, 2022, 62(3): ezac163.
14. Heiden BT, Eaton DB Jr, Chang SH, et al. Assessment of duration of smoking cessation prior to surgical treatment of non-small cell lung cancer. Ann Surg, 2023, 277(4): e933-e940.
15. Pierre S, Rivera C, Le Maître B, et al. Guidelines on smoking management during the perioperative period. Anaesth Crit Care Pain Med, 2017, 36(3): 195-200.
16. Argudo N, Rodó-Pin A, Martínez-Llorens J, et al. Feasibility, tolerability, and effects of exercise-based prehabilitation after neoadjuvant therapy in esophagogastric cancer patients undergoing surgery: an interventional pilot study. Dis Esophagus, 2021, 34(4): doaa086.
17. Pu CY, Batarseh H, Zafron ML, et al. Effects of preoperative breathing exercise on postoperative outcomes for patients with lung cancer undergoing curative intent lung resection: a meta-analysis. Arch Phys Med Rehabil, 2021, 102(12): 2416-2427. e4.
18. Yilmaz M, Çelik M. The effects of preoperative fasting on patients undergoing thoracic surgery. J Perianesth Nurs, 2021, 36(2): 167-173.
19. Gillis C, Ljungqvist O, Carli F. Prehabilitation, enhanced recovery after surgery, or both? A narrative review. Br J Anaesth, 2022, 128(3): 434-448.
20. Joshi GP, Abdelmalak BB, Weigel WA, et al. Domino KB. 2023 American Society of Anesthesiologists practice guidelines for preoperative fasting: carbohydrate-containing clear liquids with or without protein, chewing gum, and pediatric fasting duration-a modular update of the 2017 American Society of Anesthesiologists practice guidelines for preoperative fasting. Anesthesiology, 2023, 138(2): 132-151.
21. Gaulton TG, Wunsch H, Gaskins LJ, et al. Preoperative sedative-hypnotic medication use and adverse postoperative outcomes. Ann Surg, 2021, 274(2): e108-e114.
22. Qiu G, Wang P, Rao J, et al. Dexmedetomidine inhibits paraventricular corticotropin-releasing hormone neurons that attenuate acute stress-induced anxiety-like behavior in mice. Anesthesiology, 2024, 140(6): 1134-1152.
23. Li C, Tao M, Chen D, et al. Transcranial direct current stimulation for anxiety during laparoscopic colorectal cancer surgery: a randomized clinical trial. JAMA Netw Open, 2024, 7(4): e246589.
24. Crabtree TD, Puri V, Bell JM, et al. Outcomes and perception of lung surgery with implementation of a patient video education module: a prospective cohort study. J Am Coll Surg, 2012, 214(5): 816-821.e2.
25. Chappell D, Heindl B, Jacob M, et al. Sevoflurane reduces leukocyte and platelet adhesion after ischemia-reperfusion by protecting the endothelial glycocalyx. Anesthesiology, 2011, 115(3): 483-491.
26. Pang QY, An R, Liu HL. Effects of inhalation and intravenous anesthesia on intraoperative cardiopulmonary function and postoperative complications in patients undergoing thoracic surgery. Minerva Anestesiol, 2018, 84(11): 1287-1297.
27. Liu J, Liang H, Cui F, et al. Spontaneous versus mechanical ventilation during video-assisted thoracoscopic surgery for spontaneous pneumothorax: a randomized trial. J Thorac Cardiovasc Surg, 2022, 163(5): 1702-1714.e7.
28. Rosboch GL, Lyberis P, Ceraolo E, et al. The anesthesiologist’s perspective regarding non-intubated thoracic surgery: a scoping review. Front Surg, 2022, 9: 868287.
29. Huang C, Huang Q, Shen Y, et al. General anaesthesia with double-lumen intubation compared to opioid-sparing strategies with laryngeal mask for thoracoscopic surgery: a randomised trial. Anaesth Crit Care Pain Med, 2022, 41(3): 101083.
30. Chen KC, Cheng YJ, Hung MH, et al. Nonintubated thoracoscopic lung resection: a 3-year experience with 285 cases in a single institution. J Thorac Dis, 2012, 4(4): 347-351.
31. Moreault O, Couture EJ, Provencher S, et al. Double-lumen endotracheal tubes and bronchial blockers exhibit similar lung collapse physiology during lung isolation. Can J Anaesth, 2021, 68(6): 791-800.
32. Somma J, Couture ÉJ, Pelletier S, et al. Non-ventilated lung deflation during one-lung ventilation with a double-lumen endotracheal tube: a randomized-controlled trial of occluding the non-ventilated endobronchial lumen before pleural opening. Can J Anaesth, 2021, 68(6): 801-811.
33. Brassard CL, Lohser J, Donati F, et al. Step-by-step clinical management of one-lung ventilation: continuing professional development. Can J Anaesth, 2014, 61(12): 1103-1121.
34. Joe YE, Lee CY, Kim N, et al. Effect of permissive hypercarbia on lung oxygenation during one-lung ventilation and postoperative pulmonary complications in patients undergoing thoracic surgery: a prospective randomised controlled trial. Eur J Anaesthesiol, 2023, 40(9): 691-698.
35. Blank RS, Colquhoun DA, Durieux ME, et al. Management of one-lung ventilation: impact of tidal volume on complications after thoracic surgery. Anesthesiology, 2016, 124(6): 1286-1295.
36. Ferrando C, Carramiñana A, Piñeiro P, et al. Individualised, perioperative open-lung ventilation strategy during one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled clinical trial. Lancet Respir Med, 2024, 12(3): 195-206.
37. Shum S, Huang A, Slinger P. Hypoxaemia during one lung ventilation. BJA Educ, 2023, 23(9): 328-336.
38. Wu XZ, Xia HM, Zhang P, et al. Effects of ultrasound-guided alveolar recruitment manoeuvres compared with sustained inflation or no recruitment manoeuvres on atelectasis in laparoscopic gynaecological surgery as assessed by ultrasonography: a randomized clinical trial. BMC Anesthesiol, 2022, 22(1): 261.
39. Baar W, Semmelmann A, Knoerlein J, et al. Risk factors for postoperative pulmonary complications leading to increased in-hospital mortality in patients undergoing thoracotomy for primary lung cancer resection: a multicentre retrospective cohort study of the German Thorax Registry. J Clin Med, 2022, 11(19): 5774.
40. Matot I, Dery E, Bulgov Y, et al. Fluid management during video-assisted thoracoscopic surgery for lung resection: a randomized, controlled trial of effects on urinary output and postoperative renal function. J Thorac Cardiovasc Surg, 2013, 146(2): 461-466.
41. Zhang J, Chen CQ, Lei XZ, et al. Goal-directed fluid optimization based on stroke volume variation and cardiac index during one-lung ventilation in patients undergoing thoracoscopy lobectomy operations: a pilot study. Clinics (Sao Paulo), 2013, 68(7): 1065-1070.
42. Li Y, Liang H, Feng Y. Prevalence and multivariable factors associated with inadvertent intraoperative hypothermia in video-assisted thoracoscopic surgery: a single-center retrospective study. BMC Anesthesiol, 2020, 20(1): 25.
43. Sessler DI, Pei L, Li K, et al. Aggressive intraoperative warming versus routine thermal management during non-cardiac surgery (PROTECT): a multicentre, parallel group, superiority trial. Lancet, 2022, 399(10337): 1799-1808.
44. Min SH, Yoon S, Yoon SH, et al. Randomised trial comparing forced-air warming to the upper or lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position. Br J Anaesth, 2018, 120(3): 555-562.
45. Liu Y, Xiao S, Yang H, et al. Postoperative pain-related outcomes and perioperative pain management in China: a population-based study. Lancet Reg Health West Pac, 2023, 39: 100822.
46. Cohen JB, Smith BB, Teeter EG. Update on guidelines and recommendations for enhanced recovery after thoracic surgery. Curr Opin Anaesthesiol, 2024, 37(1): 58-63.
47. Kweon DE, Koo Y, Lee S, et al. Postoperative infusion of a low dose of dexmedetomidine reduces intravenous consumption of sufentanil in patient-controlled analgesia. Korean J Anesthesiol, 2018, 71(3): 226-231.
48. Feray S, Lubach J, Joshi GP, et al. PROSPECT guidelines for video-assisted thoracoscopic surgery: a systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia, 2022, 77(3): 311-325.
49. Maxwell C, Nicoara A. New developments in the treatment of acute pain after thoracic surgery. Curr Opin Anaesthesiol, 2014, 27(1): 6-11.
50. Fang B, Wang Z, Huang X. Ultrasound-guided preoperative single-dose erector spinae plane block provides comparable analgesia to thoracic paravertebral block following thoracotomy: a single center randomized controlled double-blind study. Ann Transl Med, 2019, 7(8): 174.
51. Elsabeeny WY, Ibrahim MA, Shehab NN, et al. Serratus anterior plane block and erector spinae plane block versus thoracic epidural analgesia for perioperative thoracotomy pain control: a randomized controlled study. J Cardiothorac Vasc Anesth, 2021, 35(10): 2928-2936.
52. Gan TJ, Diemunsch P, Habib AS, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg, 2014, 118(1): 85-113.
53. Feng CD, Xu Y, Chen S, et al. Opioid-free anaesthesia reduces postoperative nausea and vomiting after thoracoscopic lung resection: a randomised controlled trial. Br J Anaesth, 2024, 132(2): 267-276.
54. Kuroda H, Sugita Y, Watanabe K, et al. Successful postoperative recovery management after thoracoscopic lobectomy and segmentectomy using an ERAS-based protocol of immediate ice cream intake and early ambulation: a 3-year study. Cancer Manag Res, 2019, 11: 4201-4207.
55. Yang F, Li L, Mi Y, et al. Effectiveness of the tailored, early comprehensive rehabilitation program (t-ECRP) based on ERAS in improving the physical function recovery for patients following minimally invasive esophagectomy: a prospective randomized controlled trial. Support Care Cancer, 2022, 30(6): 5027-5036.
56. Chen K, Yu S, Zhang Z, et al. Investigation and analysis of influencing factors of early activity compliance of patients after minimally invasive esophagectomy. Ann Palliat Med, 2021, 10(12): 12657-12663.
57. Okur E, Baysungur V, Tezel C, et al. Comparison of the single or double chest tube applications after pulmonary lobectomies. Eur J Cardiothorac Surg, 2009, 35(1): 32-36.
58. Refai M, Brunelli A, Salati M, et al. The impact of chest tube removal on pain and pulmonary function after pulmonary resection. Eur J Cardiothorac Surg, 2012, 41(4): 820-823.
59. 高尊正, 冯艳, 孙德峰. 加速康复外科理念下的日间手术麻醉管理. 华西医学, 2023, 38(2): 170-179.

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