Effect of ERAS-based refined nursing on postoperative pain management in lung cancer surgery patients

Background Postoperative pain after lung cancer surgery can delay mobilization and recovery. We evaluated whether ERAS based refined nursing is associated with improved early pain recovery and reduced opioid use. Methods In this retrospective cohort study at Tangshan People's Hospital, consecutive lung cancer surgery patients from October 2024 to October 2025 received ERAS based refined nursing or routine care. The primary outcome was pain trajectory from postoperative day zero to day three. Secondary endpoints included the area under the pain curve, morphine milligram equivalents, rescue analgesia, time to ambulation, length of stay, and short-term safety outcomes. The pain trajectory was assessed using a linear mixed-effects model. Multivariable linear regression models were used for continuous outcomes, and logistic regression models were fitted for binary outcomes. Results Among 164 patients, 70 received ERAS-based refined nursing and 94 received routine care. The ERAS group showed lower pain scores from postoperative day 1 to day 3, lower opioid consumption, and fewer rescue analgesia events. In total-effect models, the group-by-time interaction for pain trajectory was significant, indicating faster pain recovery in the ERAS group. ERAS was also associated with lower cumulative pain burden, lower opioid consumption, shorter postoperative length of stay, and lower odds of rescue analgesia. Assessed safety outcomes were similar between groups. Conclusions ERAS-based refined nursing was associated with faster early pain recovery, lower opioid requirements, and shorter hospitalization after lung cancer surgery.