Does Reduction of Postoperative Opioid Use Lessen Opioid Dependence After Lung Resection for Cancer?

The opioid epidemic is a major public health crisis. Thoracotomy and minimally invasive chest surgery both carry a higher risk of severe postoperative acute pain and subsequent development of persistent opioid use compared to other incisions. Effective pain management strategies are crucial to reduce the incidence of post-thoracotomy pain, but the impact of opioid-sparing inpatient strategies on long-term dependency remains unclear. This review examines the role of postoperative opioid use in long-term dependency for lung resection patients. Despite variations in practice patterns and opioid tracking challenges, evidence indicates that enhanced recovery protocols (ERP) with multimodal pain management can significantly reduce perioperative and prolonged opioid use. We recommend use of an established ERP, aggressive perioperative counseling on opioid use expectations, and employing a multidisciplinary approach for tracking long-term dependency. The thoracic surgeon’s role in addressing the opioid crisis is critical during the perioperative period, where impactful strategies can reduce long-term opioid dependence.