Pharmacological managment of Postoperative Pain and Complications in Thoracic Surgery

Abstract

This thesis examines postoperative pain management after thoracic surgery, where nociceptive, inflammatory, neuropathic, and central sensitization mechanisms often occur together. Poorly controlled pain can impair breathing, coughing, mobilization, cardiovascular stability, and cognitive recovery, and may contribute to chronic post-thoracotomy pain. Opioids remain useful for severe pain but are limited by sedation, respiratory depression, tolerance, and other adverse effects. Therefore, non-opioid drugs, adjuvant agents, and regional techniques are combined within a multimodal, opioid-sparing strategy. The main goal is functional analgesia that allows deep breathing, physiotherapy, and early mobilization while minimizing toxicity. Overall, treatment should be mechanism-based and individualized according to the patient’s age, comorbidities, organ function, surgical approach, and risk of complications.