• J. Cardiothorac. Vasc. Anesth. · May 2024

    Randomized Controlled Trial

    Impact of Surgical Positioning on the Occurrence of Postoperative Ipilateral Shoulder Pain After Lung Resection by Video-Assisted Thoracoscopy: A Randomized Trial.

    • Geraud Galvaing, Jean Bussières, Serge Simard, Etienne J Couture, Catherine Cournoyer, Massimo Conti, Yves Lacasse, and Anne Sophie Laliberté.
    • Institut Universitaire de Cardiologie et de Pneumologie de Québec, Multidisciplinary Department of Pulmonology and Thoracic Surgery, Québec City, Québec, Canada; Jean Perrin Cancer Center, Department of Thoracic and Endocrine Surgery, Clermont-Ferrand, France.
    • J. Cardiothorac. Vasc. Anesth. 2024 May 1; 38 (5): 119011971190-1197.

    ObjectiveThe 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.DesignA prospective randomized controlled trial.SettingA single academic center study.ParticipantsPatients 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.InterventionsPatients randomly were assigned with a 1:1 ratio to a supported or suspended ipsilateral arm position.Measurements And Main ResultsIpsilateral 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.ConclusionsIpsilateral arm position seems to have no impact on ipsilateral shoulder pain.Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.

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