Objective: To evaluate the efficacy of a perioperative pain management protocol based on evidence-based nursing principles in patients undergoing thoracoscopic surgery for lung cancer. Methods: A total of 112 patients undergoing thoracoscopic lung cancer surgery in the Department of Thoracic Surgery at a specific hospital between August 2025 and March 2026 were selected and randomly assigned to either a control group or an observation group, with 56 patients in each group. The control group received standard pain management, while the observation group received a pain management protocol based on evidence-based nursing. Results: At various postoperative time points, the observation group demonstrated significantly lower pain scores, both at rest and during activity, compared to the control group. Furthermore, within the first 48 hours post-surgery, the observation group consumed fewer opioids, mobilized out of bed earlier, experienced shorter postoperative hospital stays, and had a lower overall incidence of complications than the control group; all these differences were statistically significant (p < 0.05). Conclusion: A perioperative pain management protocol established upon evidence-based nursing principles can effectively alleviate postoperative pain in patients undergoing thoracoscopic lung cancer surgery, reduce opioid consumption, facilitate postoperative recovery, lower the incidence of complications, and enhance patient satisfaction with nursing care.