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.

Very restrictive or liberal fluid regimes should be avoided in favour of euvoleamia(Evidence level: Moderate;Recommendation grade: Strong). Intraoperative hypoperfusion can be avoided with the use of vasopressors and a limited amount of fluid. Goal-directed therapy(GDT) and the use of non-invasive cardiac output monitors do not currently appear to offer benefits to the thoracic surgical patient. Balanced crystalloids are the intravenous fluid of choice (Evidence level:High;Recommendation grade:Strong) and should be discontinued as soon as possible in the postoperative period to be replaced with oral fluids and diet(Evidence level:Moderate (extrapolated);Recommendation grade:Strong).

In patients with normal preoperative renal function, monitoring of perioperative urine output does not affect renal outcomes, and a transurethral catheter is unnecessary for the sole purpose of monitoring urine output（Evidence level:A transurethral catheter is not required if its sole purpose is monitoring perioperative urine output: Moderate；Recommendation grade:A transurethral catheter is not required if its sole purpose is monitoring perioperative urine output: Strong）. Postoperative urinary retention is common, but no validated system exists to identify or prophylactically manage high-risk patients. Postoperative urinary retention is associated with thoracic epidural analgesia（TEA）, and it is reasonable to insert a transurethral catheter in these patients（Evidence level:Low；Recommendation grade: Strong.）. A recommendation on the timing of removal cannot be made.

Patients should be mobilized within 24 h of surgery（Evidence level:Low；Recommendation grade:Strong). Prophylactic minitracheostomy（MT）use may be considered in certain high-risk patients（Evidence level:Low；Recommendation grade:Weak）. Although Incentive spirometry（IS） is often used as a low-risk adjunct to physiotherapy, its benefits are unclear. The routine use of postoperative non-invasive positive pressure ventilation cannot be recommended.