To investigate the factors influencing postoperative pain in patients with nonsmall cell lung cancer (NSCLC) after thoracoscopic surgery.

Eightyseven non-small cell lung cancer patients who underwent thoracoscopic lobectomy in our hospital from April 2023 to May 2025 were selected. They were followed up for 3 months after surgery and divided into groups according to the numeric rating scale (NRS) score: 40 patients with postoperative pain (NRS>3) were assigned to the observation group, and 47 patients without pain (NRS≤3) were assigned to the control group. Clinical data and perioperative indicators were compared between the two groups.

Among the 87 patients, 40 cases(45.98%) experienced pain at 3 months after surgery. The observation group had a higher proportion of preoperative chestback pain 15 cases (37.50%), higher postoperative analgesic dosage (28.58±3.88)mg, and longer hospital stay (13.18±2.48)d compared with the control group [preoperative chestback pain 5 cases (10.64%), postoperative analgesic dosage (22.75±4.02) mg, hospital stay(9.91±1.80)d (P<0.05). Logistic regression analysis showed that preoperative chestback pain (OR=6.620, 95%CI: 1.511~28.992), postoperative analgesic dosage (OR=1.269, 95%CI: 1.055~1.526), and hospital stay (OR=1.716, 95%CI: 1.222~2.409) were influencing factors for postoperative pain in non-small cell lung cancer patients after thoracoscopic surgery (P<0.05). Preoperative chest and back pain, postoperative analgesic dosage, and hospital stay predicted the area under the receiver operating characteristic (ROC) curve for postoperative pain in patients with non-small cell lung cancer undergoing thoracoscopic surgery, with values of 0.634, 0.855, and 0.853, respectively. The combined prediction of the three factors yielded an AUC of 0.918 (95%CI: 0.853~0.983), which was superior to the individual prediction of preoperative chestback pain (Z=5.926, P=0.000), postoperative analgesic dosage (Z=2.188, P=0.029), or hospital stay (Z=2.107, P=0.035).

Preoperative chestback pain, postoperative analgesic dosage, and hospital stay are influencing factors for pain at 3 months after thoracoscopic surgery in non-small cell lung cancer patients, and their combined prediction has clinical significance.