This review focuses on the establishment and implementation of well-defined, evidence-based clinical pathways in thoracic and abdominal surgeries, to facilitate improved outcomes and avoid complications, enabling rapid recognition and treatment of complications. Ultimately, this will facilitate the recovery process and return to baseline activity. Patients scheduled for either thoracic or abdominal surgery often have compromised cardiopulmonary and metabolic functions before surgery, and the procedure itself may decrease patients' reserve. Postoperative pain acts as an additional insult to body reserve, and regional anesthesia can be the most efficient technique to attenuate this. The greatest postoperative challenge for anesthetists is to attenuate the stress response and pain sufficiently so that functions are not compromised even further. Even the best postoperative regional analgesic techniques require a smooth and timely transition to oral multimodal pain strategies to maximize their benefits.