A randomized prospective trial to assess whether the use of loco regional anesthesia as adjuvant analgesic therapy is more effective of intravenous analgesia only.

A prospective randomized trial comparing intravenous analgesia alone and in association with loco regional anesthesia consisting in a homolateral Serratus Plan Block (SPB). Loco regional blockade of the serratus is further examined by allocating the patients to two different approaches: the block being performed under US guidance by the Anesthesiologist before the beginning of the procedure, or under direct visualization, by the operating surgeon, before entering the pleural cavity.

Inclusion Criteria:

• Lobectomy/ Segmentectomy plus lymphadenectomy (systematic or sampling) for cancer (not necessarily NSCLC) performed with a standardized, three portal minimally invasive approach.

Exclusion Criteria:

• Patients who are pregnant or lactating
• Morbid obesity (BMI > 35 )
• Inability to understand and sign the Informed consent
• Proven allergy to local anesthetic drugs as required by this protocol
• Patients under chronic analgesics or neuroleptic therapy for any reason and/ or with baseline pain score (NRS scale) of 3 or more.

Given the trial Design, it would be impossible to blind the caregiver about the type of treatment.

Serratus Plan Block will be performed after the induction of General Anesthesia, the patients will thus be unaware wether being assigned to the Experimental or Control Arm.

Clarification (May 28, 2018):

• Nurses assess NRS (Pain Perception) and directly manage rescue doses delivery
• Physiotherapists deliver rehab. respiratory exercises and directly assess patient's performance.

Since their reports are directly elicited in Clinical Report Forms, they are considered outcome assessors.

Both Nurses and Physiotherapists are unaware of treatment allocation.