Purpose: Our study aimed to assess whether the type of regional anesthesia influenced the incidence of chronic postthoracotomy pain syndrome (CPTPS).Methods: This was a prospective, randomized study that included 300 patients undergoing lung cancer resection using thoracotomy. They were randomized into three groups: paravertebral nerve block (PVB), thoracic epidural anesthesia (TEA), and intercostal nerve block (INB). General anesthesia was similar in the groups. A horizontal visual analogue scale (VAS) was used to assess the intensity of the pain syndrome. It was assessed and recorded 7 days, 1 month, and 6 months after surgery.Results: At 6 months after surgery, the incidence (p <0.05) of the CPTPS was higher in the INB group (40%) than in the TEA group (23%). The CPTPS frequency in the PVB group did not differ from the other groups (34%).Conclusion: The use of the TEA in patients who underwent open lung cancer surgery contributed to a significant decline in the CPTPS frequency compared to patients who were administered INB. Using PVB did not decrease the CPTPS frequency.

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Bladder cancer is one of the most common malignant diseases involving the urinary system. Accurate prediction of the disease course and outcome is crucial for choosing an appropriate treatment strategy in these patients. Currently, there are several prognostic models for predicting non-muscle invasive bladder cancer outcomes. The scoring systems developed by the European Organization for Research and Treatment of Cancer (EORTC) and the Spanish Urological Club for Oncological Treatment (CUETO) are the most widely used prognostic models for bladder cancer. Despite the undeniable merits of these scales, they need to be supplemented. Since the prognostic score has a direct impact on the treatment strategy, intensity and costs of postoperative follow-up, and outcome, its accuracy should be higher than it is now. Identifying the additional parameters that would increase the robustness of these models is one of the major challenges for researchers.The molecular and genetic characteristics of the tumor, that can be estimated after the first surgery, are probably the best candidates for this role. The main limitation of these prognostic models lies in the fact that they assess only morphological properties of the tumor, while the most important molecular characteristics are neglected. These scoring systems do not evaluate clinical factors, concomitant diseases, and iatrogenic complications occurring during the treatment of relapses. The assessment of molecular mechanisms and clinical characteristics underlying the development of non-muscle-invasive bladder cancer as well as identification of key molecular markers, that could complement the currently existing risk assessment models, are the most important goals for researchers dealing with bladder cancer. It will significantly improve predictive capabilities of these models, ensuring the choice of an optimal treatment strategy.

In recent years, the treatment of acute pain syndrome has been considered as an independent direction in anesthesiology and intensive care. New schemes of postoperative analgesia and new drugs developed by pharmacologists are actively being introduced. One of the newer regimens for pain relief is patient-controlled analgesia (CPA) or on-demand analgesia. The development of the concept of fast track surgery, one of the most widely discussed areas for the development of innovative technologies in modern surgery, from the point of view of the anesthesiologist of the resuscitation specialist, minimizes the stress response of the body to surgical aggression at all stages of the perioperative period. Increasingly, the method of preemptive analgesia is used more widely, based on the use of analgesics before the start of the operation, which helps to prevent the occurrence of peripheral and central sensitization.

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