The current (and possible future) role of opioid analgesia in lung cancer surgery

The objectives of this minireview are two-fold. The first is to discuss the evolution of opioid analgesia in perioperative medicine in the context of thoracic non-cardiac surgery. Current standard-of-care, aiming to optimize analgesia and limit undesirable side effects, is discussed in the context of multimodal analgesia, specifically enhanced recovery after thoracic surgery pathways. The second is to review a developing research program that may ultimately add another element to the personalization of analgesic plans for individual cancer patients based on optimizing oncological outcomes. Termed “precision oncoanalgesia,” this emerging field aims to elucidate how individual patient-specific tumor omics (genomics, transcriptomics, etc.) may mediate the effects of analgesic drugs on oncological recurrence and survival.