Surgical Positioning of the Arm During Thoracic Surgery -Effect on Shoulder Pain After Surgery?

Study Overview
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Brief Summary
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Up to 85% experience shoulder pain after thoracic surgery, especially on the same side as surgery are performed. Referred phrenic nerve pain is probably one cause of ipsilateral shoulder pain (ISP), and positioning of the arm during surgery another. Studies indicates that ISP can be caused by the positioning of the patient during surgery due to muscle -and ligament strain. Can a change in the surgical positioning (less press and stretch) of the ipsilateral arm effect the shoulder pain after thoracic surgery?

Official Title
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Lateral Surgical Positioning for Thoracic Surgery -Effect on Ipsilateral Shoulder Pain?

Conditions
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Lung Cancer

Intervention / Treatment
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* Procedure: Modified lateral positioning.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women;18 years and older Thoracotomy for lung cancer Video assisted thoracic surgery for lung cancer. Exclusion Criteria: Received treatment for shoulder pain Use pain medication on regular basis Under 18 year Length of stay in ICU more than 24 hours after surgery Does not understand the native language

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Standard lateral positioning<br> | |
| Experimental: Modified lateral positioning<br>Modified lateral positioning. This will ensure less pressure and stretch on shoulder than standard lateral positioning. | Procedure: Modified lateral positioning.<br>* Right before surgery, the patient are posistioned in lateral position with arm elevated (not more than 90 degree from torso). In the intervention, the arm will be lowered and placed in towards the torso for patients enrolled in the experimantal arm.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative shoulder pain after lung surgery. | Using visual analog scale for assesing pain in the shoulder (Scale from 0-10). Mesauring times: VAS pain related to the shoulder before surgery, VAS pain shoulder at day 1 and 3 after surgery. Further will Oslo University Hospital scheme for registration of pain for location and characteristic also be used. | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain medication | All extra pain medication patient use after surgery until day 4, type and dose, will be mesaured. | 3 months | 
| White blood cell | Mesaured before surgery, and at day 1 and 3 after surgery. | 3 months | 
| C reactive protein | Measured before surgery, and at day 1 and 3 after surgery. | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ipsilateral shoulder pain, Surgical positioning, Lung cancer, Thoracotomy, Video assisted thoracic surgery