Opioid Free Anaesthesia-Analgesia Strategy on Surgical Stress and Immunomodulation in Elective VATS-Lobectomy for NSCLC

Neutrophil to Lymphocyte ratio (NLR) is a prognostic index that predicts patients' overall survival. Higher NLR has been correlated with worse outcome.

Platelet to Lymphocyte ratio (PLR) is a prognostic index that predicts patients' overall survival. Higher PLR has been correlated with worse outcome.

Lymphocyte to monocyte ratio (LMR) is a prognostic index that predicts patients' overall survival. Lower LMR has been correlated with worse outcome.

Advanced Lung Cancer Inflammation Index (ALI) is a prognostic index that predicts patients' recurrence-free survival and overall survival. ALI is calculated as (BMI x Alb / NLR) where BMI = body mass index, Alb = serum albumin, NLR (neutrophil lymphocyte ratio, a marker of systemic inflammation). Higher ALI scores have been correlated with worse outcome.

Systemic Immune Inflammation Index (SII) is a prognostic index that predicts patients' overall survival. SII is calculated as follows: SII = platelet count × neutrophil/lymphocyte count. Higher SII scores have been correlated with worse outcome.

Prognostic Nutritional Index (PNI) is a prognostic index that predicts patients' overall survival. PNI is calculated as follows: PNI = 10 × serum albumin value (g/dL) + 0.005 × total lymphocyte count (per mm3) in the peripheral blood. Higher PNI scores have been correlated with worse outcome.

Inflammatory response and stress response as quantified by IL-6 serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by IL-6 serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by IL-6 serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by IL-8 serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by IL-8 serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by IL-8 serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by IL-10 serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by IL-10 serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by IL-10 serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by TNF-a serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by TNF-a serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by TNF-a serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by CRP serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by CRP serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by CRP serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by WBC count. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by WBC count. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by WBC count. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by AVP serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by AVP serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by AVP serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by cortisol serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by cortisol serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by cortisol serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by HIF-1α serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by HIF-1α serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by HIF-1α serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by VEGF serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by VEGF serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by VEGF serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by NF-κB serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by NF-κB serum levels. Blood sample collection will take place in both study groups

Inflammatory response and stress response as quantified by NF-κB serum levels. Blood sample collection will take place in both study groups

Haemodynamic Stability as quantified by hemodynamic markers, specifically Pulse Rate - PR. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Mean PR will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Pulse Rate - PR. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Minimum PR will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Pulse Rate - PR. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Maximum PR will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Pulse Rate - PR. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Standard Deviation PR will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Pulse Rate change 1 minute after anesthesia induction, compared to 1 minute prior. Data will be collected from a pulse contour analysis monitor.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Pulse Rate change 1 minute after surgical incision, compared to 1 minute prior. Data will be collected from a pulse contour analysis monitor.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Systolic Blood Pressure - SBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Mean SBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Systolic Blood Pressure - SBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Minimum SBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Systolic Blood Pressure - SBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Maximum SBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Systolic Blood Pressure - SBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Standard Deviation SBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Systolic Blood Pressure change 1 minute after anesthesia induction, compared to 1 minute prior. Data will be collected from a pulse contour analysis monitor.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Systolic Blood Pressure change 1 minute after surgical incision, compared to 1 minute prior. Data will be collected from a pulse contour analysis monitor.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Diastolic Blood Pressure - DBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Mean DBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Diastolic Blood Pressure - DBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Minimum DBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Diastolic Blood Pressure - DBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Maximum DBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Diastolic Blood Pressure - DBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Standard Deviation DBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Diastolic Blood Pressure change 1 minute after anesthesia induction, compared to 1 minute prior. Data will be collected from a pulse contour analysis monitor.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Diastolic Blood Pressure change 1 minute after surgical incision, compared to 1 minute prior. Data will be collected from a pulse contour analysis monitor.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Mean Blood Pressure - MBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Mean MBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Mean Blood Pressure - MBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Minimum MBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Mean Blood Pressure - MBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Maximum MBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Mean Blood Pressure - MBP. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Standard Deviation MBP will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Mean Blood Pressure change 1 minute after anesthesia induction, compared to 1 minute prior. Data will be collected from a pulse contour analysis monitor.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Mean Blood Pressure change 1 minute after surgical incision, compared to 1 minute prior. Data will be collected from a pulse contour analysis monitor.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Cardiac Output - CO. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Mean CO will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Cardiac Output - CO. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Minimum CO will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Cardiac Output - CO. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Maximum CO will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Cardiac Output - CO. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Standard Deviation CO will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Cardiac Index - CI. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Mean CI will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Cardiac Index - CI. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Minimum CI will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Cardiac Index - CI. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Maximum CI will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Cardiac Index - CI. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Standard Deviation CI will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume - SV. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Mean SV will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume - SV. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Minimum SV will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume - SV. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Maximum SV will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume - SV. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Standard Deviation SV will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume Variation - SVV. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Mean SVV will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume Variation - SVV. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Minimum SVV will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume Variation - SVV. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Maximum SVV will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume Variation - SVV. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Standard Deviation SVV will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume Index - SVI. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Mean SVI will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume Index - SVI. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Minimum SVI will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume Index - SVI. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Maximum SVI will be reported for each patient, extracted from the collected data.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Stroke Volume Index - SVI. Data will be collected from a pulse contour analysis monitor, and values will be collected every 20 seconds. Standard Deviation SVI will be reported for each patient, extracted from the collected data.

Intraoperative Tachycardia (defined as PR≥ 100 bpm), with episodes lasting ≥1 minute. Data will be reported in total seconds of intraoperative tachycardia.

Intraoperative Bradycardia (defined as PR≤ 60 bpm), with episodes lasting ≥1 minute. Data will be reported in total seconds of intraoperative bradycardia.

Intraoperative Hypotension (defined as SBP≤100mmHg or ≤70% of preoperative Baseline), with episodes lasting ≥1 minute. All patients will have a 5 minute preoperative SBP baseline, with measurements every 20 seconds. Intraoperative data will be compared to the mean preoperative 5 minute SPB baseline. Data will be reported in total seconds of intraoperative hypotension.

Intraoperative Hypertension (defined as SBP ≥130% of preoperative Baseline), with episodes lasting ≥1 minute. All patients will have a 5 minute preoperative SBP baseline, with measurements every 20 seconds. Intraoperative data will be compared to the mean preoperative 5 minute SPB baseline. Data will be reported in total seconds of intraoperative hypertension.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Crystalloid Fluid Requirements.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Colloid Fluid Requirements.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Concentrated Red Blood Cell unit Requirements.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Plasma unit Requirements.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Platelet unit Requirements.

Haemodynamic Stability as quantified by hemodynamic markers, specifically Blood Loss

Haemodynamic Stability as quantified by hemodynamic markers, specifically Fluid Balance

Haemodynamic Stability as quantified by hemodynamic markers, specifically Adrenaline requirements

Haemodynamic Stability as quantified by hemodynamic markers, specifically Noradrenaline requirements

Haemodynamic Stability as quantified by hemodynamic markers, specifically Ephedrine requirements

Haemodynamic Stability as quantified by hemodynamic markers, specifically Phenylephrine requirements

Haemodynamic Stability as quantified by hemodynamic markers, specifically Dopamine requirements

Haemodynamic Stability as quantified by hemodynamic markers, specifically Dobutamine requirements

Haemodynamic Stability as quantified by hemodynamic markers, specifically Nitroglycerine requirements

Evaluation of patients' pain using scales: Numerical Rating Scale (NRS). The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable").

Evaluation of patients' pain using scales: Numerical Rating Scale (NRS). The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable").

Evaluation of patients' pain using scales: Numerical Rating Scale (NRS). The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable").

Evaluation of patients' pain using scales: Numerical Rating Scale (NRS). The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable").

Evaluation of patients' pain using scales: Critical Care Pain Observation Tool (CPOT). The scale consists of four behavioral domains: facial expression, body movements, muscle tension and compliance with the ventilation for intubated patients or vocalization for extubated patients. Patient's behavior in each domain is scored between 0 and 2. The possible total score ranges from 0 (no pain) to 8 (maximum pain).

Evaluation of patients' pain using scales: Critical Care Pain Observation Tool (CPOT). The scale consists of four behavioral domains: facial expression, body movements, muscle tension and compliance with the ventilation for intubated patients or vocalization for extubated patients. Patient's behavior in each domain is scored between 0 and 2. The possible total score ranges from 0 (no pain) to 8 (maximum pain).

Evaluation of patients' pain using scales: Critical Care Pain Observation Tool (CPOT). The scale consists of four behavioral domains: facial expression, body movements, muscle tension and compliance with the ventilation for intubated patients or vocalization for extubated patients. Patient's behavior in each domain is scored between 0 and 2. The possible total score ranges from 0 (no pain) to 8 (maximum pain).

Evaluation of patients' pain using scales: Critical Care Pain Observation Tool (CPOT). The scale consists of four behavioral domains: facial expression, body movements, muscle tension and compliance with the ventilation for intubated patients or vocalization for extubated patients. Patient's behavior in each domain is scored between 0 and 2. The possible total score ranges from 0 (no pain) to 8 (maximum pain).

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Intolerable" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Intolerable" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Intolerable" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Tolerable with Discomfort" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Tolerable with Discomfort" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Tolerable with Discomfort" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Comfortably manageable" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Comfortably manageable" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Comfortably manageable" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Negligible Pain" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Negligible Pain" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to how comfortable patients feel with their pain, available answers will be:

• Intolerable
• Tolerable with discomfort
• Comfortably manageable
• Negligible Pain

The percentage of patients that report pain that is "Negligible Pain" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to changes in pain perception by patients, available answers will be:

• Getting worse
• About the same
• Getting better

The percentage of patients that report pain that is "Getting worse" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to changes in pain perception by patients, available answers will be:

• Getting worse
• About the same
• Getting better

The percentage of patients that report pain that is "Getting worse" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to changes in pain perception by patients, available answers will be:

• Getting worse
• About the same
• Getting better

The percentage of patients that report pain that is "Getting worse" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to changes in pain perception by patients, available answers will be:

• Getting worse
• About the same
• Getting better

The percentage of patients that report pain that is "About the same" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to changes in pain perception by patients, available answers will be:

• Getting worse
• About the same
• Getting better

The percentage of patients that report pain that is "About the same" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to changes in pain perception by patients, available answers will be:

• Getting worse
• About the same
• Getting better

The percentage of patients that report pain that is "About the same" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to changes in pain perception by patients, available answers will be:

• Getting worse
• About the same
• Getting better

The percentage of patients that report pain that is "Getting Better" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to changes in pain perception by patients, available answers will be:

• Getting worse
• About the same
• Getting better

The percentage of patients that report pain that is "Getting Better" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to changes in pain perception by patients, available answers will be:

• Getting worse
• About the same
• Getting better

The percentage of patients that report pain that is "Getting Better" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to pain control reported by patients, available answers will be:

• Inadequate pain control
• Effective, just about right
• Would like to reduce medication

The percentage of patients that report "Inadequate pain control" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to pain control reported by patients, available answers will be:

• Inadequate pain control
• Effective, just about right
• Would like to reduce medication

The percentage of patients that report "Inadequate pain control" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to pain control reported by patients, available answers will be:

• Inadequate pain control
• Effective, just about right
• Would like to reduce medication

The percentage of patients that report "Inadequate pain control" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to pain control reported by patients, available answers will be:

• Inadequate pain control
• Effective, just about right
• Would like to reduce medication

The percentage of patients that report "Effective, just about right" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to pain control reported by patients, available answers will be:

• Inadequate pain control
• Effective, just about right
• Would like to reduce medication

The percentage of patients that report "Effective, just about right" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to pain control reported by patients, available answers will be:

• Inadequate pain control
• Effective, just about right
• Would like to reduce medication

The percentage of patients that report "Effective, just about right" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to pain control reported by patients, available answers will be:

• Inadequate pain control
• Effective, just about right
• Would like to reduce medication

The percentage of patients that report "Would like to reduce medication" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to pain control reported by patients, available answers will be:

• Inadequate pain control
• Effective, just about right
• Would like to reduce medication

The percentage of patients that report "Would like to reduce medication" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to pain control reported by patients, available answers will be:

• Inadequate pain control
• Effective, just about right
• Would like to reduce medication

The percentage of patients that report "Would like to reduce medication" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Can't do anything because of pain" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Can't do anything because of pain" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Can't do anything because of pain" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Pain keeps me from doing most of what I need to do" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Pain keeps me from doing most of what I need to do" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Pain keeps me from doing most of what I need to do" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Can do most things, but pain gets in the way of some" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Can do most things, but pain gets in the way of some" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Can do most things, but pain gets in the way of some" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Can do everything I need to do" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Can do everything I need to do" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to functioning - for the usual things patients need to do, available answers will be:

• Can't do anything because of pain
• Pain keeps me from doing most of what I need to do
• Can do most things, but pain gets in the way of some
• Can do everything I need to do

The percentage of patients whose functioning is reported as "Can do everything I need to do" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to sleep, if the pain is waking patients up, available answers will be:

• Awake with pain most of the night
• Awake with occasional pain
• Normal sleep

The percentage of patients whose sleep is reported as "Awake with pain most of the night" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to sleep, if the pain is waking patients up, available answers will be:

• Awake with pain most of the night
• Awake with occasional pain
• Normal sleep

The percentage of patients whose sleep is reported as "Awake with pain most of the night" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to sleep, if the pain is waking patients up, available answers will be:

• Awake with pain most of the night
• Awake with occasional pain
• Normal sleep

The percentage of patients whose sleep is reported as "Awake with pain most of the night" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to sleep, if the pain is waking patients up, available answers will be:

• Awake with pain most of the night
• Awake with occasional pain
• Normal sleep

The percentage of patients whose sleep is reported as " Awake with occasional pain" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to sleep, if the pain is waking patients up, available answers will be:

• Awake with pain most of the night
• Awake with occasional pain
• Normal sleep

The percentage of patients whose sleep is reported as " Awake with occasional pain" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to sleep, if the pain is waking patients up, available answers will be:

• Awake with pain most of the night
• Awake with occasional pain
• Normal sleep

The percentage of patients whose sleep is reported as " Awake with occasional pain" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to sleep, if the pain is waking patients up, available answers will be:

• Awake with pain most of the night
• Awake with occasional pain
• Normal sleep

The percentage of patients whose sleep is reported as "Normal sleep" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to sleep, if the pain is waking patients up, available answers will be:

• Awake with pain most of the night
• Awake with occasional pain
• Normal sleep

The percentage of patients whose sleep is reported as "Normal sleep" will be reported

Evaluation of patients' pain using scales: Clinically Aligned Pain Assessment Tool (CAPA). Patients will be given a standardized CAPA questionaire that has pre-determined answers that patients will be able to choose from, to best describe their pain. In regards to sleep, if the pain is waking patients up, available answers will be:

• Awake with pain most of the night
• Awake with occasional pain
• Normal sleep

The percentage of patients whose sleep is reported as "Normal sleep" will be reported

Evaluation of patients' pain by recording the number of times that rescue analgesia (tramadol) was required.

Evaluation of patients' pain by recording the number of times that rescue analgesia (tramadol) was required.

Evaluation of patients' pain by recording the number of times that rescue analgesia (tramadol) was required.

Aspiration pneumonitis (defined as respiratory failure after the inhalation of regurgitated gastric contents)

Moderate respiratory failure (SpO2 < 90% or PaO2 < 60 mmHg for 10 min in room air, responding to oxygen > 2 L/min)

Severe respiratory failure (need for non-invasive or invasive mechanical ventilation due to poor oxygenation)

Adult respiratory distress syndrome (mild, moderate, or severe according to the Berlin definition)

Pulmonary infection (defined as new or progressive radiographic infiltrate plus at least two of the following: antibiotic treatment, tympanic temperature > 38 °C, leukocytosis or leucopenia (white blood cell (WBC) count < 4000 cells/mm3 or > 12,000 cells/mm3) and/or purulent secretions)

Atelectasis (suggested by lung opacification with shift of the mediastinum, hilum, or hemidiaphragm towards the affected area, and compensatory over-inflation in the adjacent non-atelectatic lung)

Cardiopulmonary edema (defined as clinical signs of congestion, including dyspnea, edema, rales, and jugular venous distention, with the chest x-ray demonstrating increase in vascular markings and diffuse alveolar interstitial infiltrates)

Pleural effusion (chest x-ray demonstrating blunting of the costophrenic angle, loss of the sharp silhouette of the ipsilateral hemidiaphragm in upright position, evidence of displacement of adjacent anatomical structures, or (in supine position) a hazy opacity in one hemithorax with preserved vascular shadows)

Pneumothorax (defined as air in the pleural space with no vascular bed surrounding the visceral pleura)

Pulmonary infiltrates (chest x-ray demonstrating new monolateral or bilateral infiltrate without other clinical signs)

Prolonged air leakage (air leak requiring at least 7 days of postoperative chest tube drainage)

Purulent pleuritic (receiving antibiotics for a suspected infection, as far as not explained by the preoperative patient condition alone)

Pulmonary embolism (as documented by pulmonary arteriogram or autopsy, or supported by ventilation/perfusion radioisotope scans, or documented by echocardiography and receiving specific therapy)

Lung hemorrhage (bleeding through the chest tubes requiring reoperation, or three or more red blood cell packs)

Evaluation of patients' pain using the standardized "Pain Detect" questionnaire. The "Pain Detect" questionnaire has been standardized for screening the presence of a neuropathic pain component. Patients will be interviewed by phone interview, 3 months after the end of surgery. The possible score a patient can have, ranges from 0 to 38.