Haager B, et al. - Whether improved analgesia and a lower incidence of pulmonary complications could be achieved with the use of regional anesthesia vs systemic analgesia with parenteral opioids in video-assisted thoracic surgery (VATS) lobectomy, was investigated in this study. In a single university hospital, anesthetic and surgical records of 103 patients who underwent VATS lobectomy were retrospectively analyzed, and comparisons were performed between regional anesthesia [ie, thoracic paravertebral blockade (group TPVB) or thoracic epidural anesthesia (group TEA)] vs a systemic opioid application [ie, patient controlled analgesia (group PCA)]. The pain level after surgery as determined by the Visual Analog Scale at rest and during coughing during 120 h was assessed as the primary endpoint. Researchers found that a comparable and effective pain relief following VATS anatomic resection was offered by analgesia with TEA, TPVB and PCA, with no side effects reported. For VATS lobectomy, PCA may serve as a sufficient alternative vs regional analgesia.