Lidocaine is an amide local anaesthetic. In recent years, clinical evidence shows that perioperative intravenous lidocaine injection plays an active role in anti-inflammation, analgesia, anti-tumor and organ protection. Postoperative pain is severe in patients after thoracic surgery, and the incidence of pulmonary complications and cognitive impairment is high. These adverse reactions and complications are closely related to the inflammatory reaction after thoracic surgery. Intravenous infusion of lidocaine may have some effects on alleviating these adverse reactions and complications. Thus, this article reviews the current status of intravenous lidocaine injection in thoracic surgery and explores the related mechanisms to optimize the management of anaesthesia during the perioperative period of thoracic surgery.