Intercostal Cryoanalgesia for Chronic Pain After VATS Lung Resection

Inclusion Criteria: * Patients scheduled for elective anatomical pulmonary resection (anatomical segmentectomy, lobectomy or bilobectomy) by VATS for lung cancer * American Society of Anesthesiologists (ASA) score 1-3 Exclusion Criteria: * Contraindication to the paravertebral block (coagulopathy, discontinuous paravertebral space, impossible thoracoscopic visualization of the paravertebral space) * Contraindication to intercostal cryoanalgesia (cold urticaria, cryoglobulinemia) * Epidural analgesia preferred (high risk of thoracotomy, marginal lung function) * Surgical criteria (conversion to thoracotomy, non anatomical wedge resection) * Preoperative thoracic or shoulder pain on the operated side * Known allergy to acetaminophen, celecoxib, sulfa, or both hydromorphone and morphine * History of thoracic surgery on the operated site * Regular use of opioids or medication with effects against neuropathic pain (tricyclics, gabapentinoids, duloxetine, venlafaxine) * Inability to understand pain scales or to communicate clearly despite adequate teaching * Contraindication to non-steroidal anti-inflammatory drugs (renal filtration rate \< 60 mL/min, active gastric ulcer) * Pregnancy * Patient refusal to participate