Routine administration of sedatives to reduce anxiety preoperatively should be avoided to hasten postoperative recovery. Alternative non-pharmacological methods to relieve preoperative anxiety should be considered in patients with severe anxiety（Evidence level: Moderate；Recommendation grade:Strong）.

Anemia before operation is related to the increase of incidence rate and mortality after operation, which should be checked and corrected before operation. Iron therapy is the first line of treatment for correcting iron deficiency anemia. When possible, blood transfusions or erythropoietic drugs should not be used to correct preoperative anemia（Evidence level:High；Recommendation grade: Strong）

Patients should be screened for nutritional status and weight loss before surgery. If there is a risk, active nutritional support should be provided（Evidence level：high ; Recommendation grade： Strong）. Oral nutritional supplements can be used to supplement total intake（Evidence level：Moderate ; Recommendation grade： Strong ）. There is not enough evidence to recommend preoperative immune enhanced nutrition (IEN) as superior to nutritional supplements, but it may play a role in postoperative malnutrition patientsEvidence level：low ; Recommendation grade：weak）

Patients should be permitted to drink clear fluids up until 2 h before anaesthesia and surgery（Evidence level:High；Recommendation grade:Strong）. Patients should abstain from solids for 6 h prior to induction of anaesthesia（Evidence level:High；Recommendation grade:Strong）. Oral carbohydrate loading reduces postoperative insulin resistance, improves preoperative well-being and should be used routinely（Evidence level:Low；Recommendation grade:Strong）

Patients undergoing major lung resection should be treated with pharmacological and mechanical VTE prophylaxis（Evidence level：Moderate；Recommendation grade：Strong）Patients at high risk of VTE may be considered for extended prophylaxis with LMWH for up to 4 weeks（Evidence level：Low；Recommendation grade：Weak）

Monitoring of patients’ temperature is mandatory to guide therapy and to avoid hypothermia and hyperthermia(Evidence level:High; Recommendation grade:Strong). Maintenance of normothermia with convective active warming devices should be used perioperatively(Evidence level:High;Recommendation grade: Strong).

The use of short-acting anaesthetics（Quality of evidence: Low ；Recommendation grade: Strong）, cerebral monitoring （Quality of evidence: High ；Recommendation grade: Strong）to improve recovery and reduce the risk for postoperative delirium, monitoring of the level and complete reversal of neuromuscular block is recommended（Quality of evidence: High ；Recommendation grade: Strong）

A combination of regional and general anaesthetic techniques should be used to permit early emergence from anaesthesia and extubation（Evidence level:Low；Recommendation grade: Strong）. Lung isolation can be provided with either a doublelumen tube or a bronchial blocker, and lung-protective ventilation strategies should be used during one-lung anaesthesia（Evidence level:Moderate；Recommendation grade: Strong）. Nonintubated anaesthesia shows potential but cannot currently be recommended for routine use（Evidence level: Low；Recommendation grade: Not recommended）. Short-acting volatile or intravenous anaesthetics, or their combination, are equivalent choices（Evidence level: Low；Recommendation grade: Strong）.

The use of non-pharmacological measures to decrease the baseline risk of postoperative nausea and vomiting（PONV） should be implemented in all patients undergoing thoracic surgery（Evidence level:High；Recommendation grade： Strong）. A multimodal pharmacological approach for PONV prophylaxis, in combination with other measures to reduce postoperative opiate consumption, is indicated in patients at moderate or high risk（Evidence level: Moderate；Recommendation grade:Strong）.

A standardized multimodal approach to pain relief, including good regional anaesthesia, is recommended with the aim of reducing postoperative opioid use（Evidence level:High；Recommendation grade:Strong）. Paravertebral blockade provides equivalent analgesia to thoracic epidural analgesia（TEA）with evidence of a better sideeffect profile. Acetaminophen and NSAIDs should be administered regularly to all patients unless contraindications exist（Evidence level:High；Recommendation grade: Strong）. Dexamethasone may be administered to prevent postoperative nausea and vomiting（PONV）and reduce pain（Evidence level:Low.Recommendation grade: Strong）. Ketamine should be considered for patients with preexisting chronic pain on long-term opiates（Evidence level: Moderate.Recommendation grade:Strong）. Gabapentin cannot currently be recommended as an adjunct to conventional analgesia.