Effect of Modified Arm Positioning on Shoulder Pain After Thoracoscopic Lobectomy
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Modified Double-Arm Wrap Positioning, Traditional Arm-Board Position.
- Who it may be relevant to
- Registry conditions: Ipsilateral Shoulder Pain, Lung Neoplasms. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- China
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Effect of Modified Bilateral Arm Wrapping Position on Postoperative Ipsilateral Shoulder Pain in Patients Undergoing Video-Assisted Thoracoscopic Lobectomy: A Prospective Randomized Controlled Trial
Overview
This study is a prospective randomized controlled trial aiming to reduce shoulder pain after lung surgery. Shoulder pain on the surgical side is common after video-assisted thoracoscopic lobectomy, affecting about 20%-58% of patients. It can limit coughing, moving, and sleeping, and may delay recovery. The pain may come from two sources: nerve stimulation during surgery and the prolonged arm position used during the operation. While nerve stimulation is hard to avoid, the arm position can be modified. Currently, most pain treatments rely on medications or nerve blocks given after surgery, which have side effects or risks. No one has tried to prevent the pain by changing the arm position during the operation. We plan to enroll 270 patients scheduled for thoracoscopic lung removal surgery at Chengdu Shangjin Nanfu Hospital. Patients will be randomly divided into two groups. One group will receive the standard side-lying position with arms extended on arm boards (traditional position). The other group will receive a modified position where both arms are bent at the elbows and wrapped with surgical drapes, without using arm boards (modified double-arm wrap position). Our main goal is to compare the rate of shoulder pain (on the operated side) within 24 hours after surgery between the two groups. We will also compare pain on the opposite shoulder, pain severity, time needed to set up the position, total surgery time, hospital stay, and any nerve or skin complications. This study has been approved by the Biomedical Ethics Review Committee of West China Hospital, Sichuan University. All participants will provide written informed consent. The findings may help improve intraoperative positioning and enhance early recovery after lung surgery.
Interventions
- Other Modified Double-Arm Wrap Positioning
Participants in this arm are placed in the standard lateral decubitus position with a thin pillow under the lower side. Both upper arms are abducted to slightly less than 90 degrees, with elbows flexed at 90 degrees. A soft pad is placed between the hands. The forearms are positioned forward above the head, and both arms are wrapped together with surgical drapes for secure fixation. No arm boards are used. This modified position is maintained throughout the entire surgical procedure. - Other Traditional Arm-Board Position
Participants in this arm are placed in the standard lateral decubitus position with a thin pillow under the lower side. The contralateral upper arm is abducted to slightly less than 90 degrees with the elbow extended, and the forearm is placed on an arm board with a strap secured at the elbow. The ipsilateral arm is similarly positioned on a separate arm board. Both arm boards are used for fixation throughout the entire surgical procedure.
Primary outcome measures
- Incidence of Ipsilateral Shoulder Pain Within 24 Hours Postoperatively [Time frame: Within the first 24 hours after surgery]
Secondary outcome measures (8)
- Incidence of Contralateral Shoulder Pain Within 24 Hours Postoperatively [Time frame: Within the first 24 hours after surgery (Postoperative Day 1, 0-24 hours)]
- VAS scores for Ipsilateral Shoulder Pain at rest and on movement at 24 h postoperatively. [Time frame: At 24 hours postoperatively]
- incidence of ipsilateral shoulder pain at postoperative day 3 [Time frame: Postoperative Day 3]
- Positioning Setup Time [Time frame: Intraoperative recording]
- Total Surgical Duration [Time frame: Intraoperative recording]
- Postoperative Hospital Stay [Time frame: At hospital discharge]
- Incidence of Brachial Plexus Injury-Related Signs Within 72 Hours Postoperatively [Time frame: Within 72 hours postoperatively]
- Position-related pressure injury within 72 h [Time frame: From the end of surgery to 72 hours postoperatively]
Eligibility criteria
Inclusion criteria
- Age ≥18 years.
- Diagnosed with pulmonary space-occupying lesion and scheduled for elective video-assisted thoracoscopic standard lobectomy.
- ASA physical status classification I-III.
- No pre-existing shoulder pain or shoulder mobility impairment prior to surgery.
- No long-term use of analgesic medications (>1 week) before surgery.
- Willing and able to provide written informed consent.
Exclusion criteria
- Severe cervical spine disease or history of brachial plexus injury.
- Cognitive impairment or psychiatric disorder precluding understanding of pain assessment scales.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Prevention
Study locations
China · 1 center
- Chengdu Shangjin Nanfu Hospita — Chengdu
Identifiers
NCT: NCT07746323 · 2025（693）