The most common indications for thoracic surgery are malignant diseases of the thoracic region (lungs, esophagus, mediastinum) and chest trauma. Thoracic surgeons have their own peculiarities and present a special challenge for anesthesiologists, since operations are performed on the open chest, and procedures performed on the lungs, since it is an organ that has the role of rapid maintenance of homeostasis. Functional disorders during surgery can be vital to the patient. Different conditions of the respiratory system of these patients are possible, so it is important to focus on the extent and severity of these conditions and their impact on the cardiovascular system and determine whether the patient will be able to undergo planned surgery to prevent postoperative complications. Preoperative determination of the condition of the respiratory system is very important because its insufficient functioning can lead to severe postoperative complications. The choice of anesthetic in thoracic surgery depends on the preoperative assessment of cardiorespiratory function. The complexity of intubation in thoracic surgery is due to the need for complete, functional separation of the lungs during surgery. Approaches to functional lung separation include: intubation with an endobronchial two-volume tube or a univent tube with a bronchial blocker. One Lung Ventilation (OLV) has significantly improved thoracic surgery. The main approach to treatment of postoperative pain in thoracic surgeons is thoracic epidural analgesia.