Objective: The aim of this study was to evaluate the impact of the ipsilateral arm position on ipsilateral shoulder pain after lung cancer resection by video-assisted thoracic surgery.
Design: A prospective randomized controlled trial.
Setting: A single academic center study.
Participants: Patients undergoing video-assisted thoracic surgery pulmonary resection for cancer at the Institut Universitaire de Cardiologie et de Pneumologie de Québec from May 2020 to May 2022 were included.
Interventions: Patients randomly were assigned with a 1:1 ratio to a supported or suspended ipsilateral arm position.
Measurements and main results: Ipsilateral shoulder pain incidence, pain score, and opioid use were recorded in the postanesthesia care unit (PACU) on postoperative days 1 and 2. One hundred thirty-three patients were randomized, 67 in the suspended-arm group and 66 in the supported-arm group. Of the patients, 31% reported ipsilateral shoulder pain in the PACU with no difference between groups (19/67 [28.4%] v 22/66 patients (33.3%), p = 0.5767). There was no significant difference between the pain score in the PACU (3 [0-6] v 4 [0-6], p = 0.9055) at postoperative day 1 (4 [2-6] v 3 [2-5], p = 0.4113) and at postoperative day 2 (2 [0-5] v 2 [1-4], p = 0.9508). Ipsilateral shoulder pain score decreased rapidly on postoperative day 2. There was no statistical difference in opioid and gabapentinoid use between the groups.
Conclusions: Ipsilateral arm position seems to have no impact on ipsilateral shoulder pain.
Keywords: Ipsilateral shoulder pain; Lung resection; Pain after thoracoscopy; Positioning; Postoperative pain; VATS.
Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.