IMPACT OF OPERATIVE POSITIONING ON THE DEVELOPMENT OF SHOULDER PAIN AFTER PULMONARY LOBECTOMY BY VATS

Study Overview
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Brief Summary
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The investigators want to be able to show a 66% decrease in the incidence of shoulder pain in the support group compared to the suspension group.

Detailed Description
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The position currently used in cases of pulmonary lobectomies by videothoracoscopy is an extension associated with an abduction of the shoulder on the side operated by suspension of the thoracic limb in a trampoline-type arm support with an angulation of more than 90 ° of the shoulder in the saggital and frontal planes. The investigators wish to prospectively and randomly compare this position currently used in the thoracic surgery service of the IUCPQ with a 2nd position which seems less restrictive for all the joints of the shoulder joint complex in which the patient's arm rests on a support placed in front of the patient's face. It follows from this position of the joint degrees less than or equal to 90 ° in all planes. This new position is not experimental, but not normally used in thoracic surgery at the IUCPQ.

Official Title
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IMPACT OF OPERATIVE POSITIONING ON THE DEVELOPMENT OF SHOULDER PAIN AFTER PULMONARY LOBECTOMY BY VATS

Conditions
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Post-thoracotomy Pain Syndrome

Intervention / Treatment
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* Other: positioning


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any patient in whom the management of a bronchopulmonary cancer, or his strong suspicion, justifies a bilobectomy, a lobectomy or a segmentectomy by videothoracoscopy. Exclusion Criteria: surgery extended to the chest wall, including extra-pleural resections, Pleurectomy, Chronic pain patient suffering from chronic pain preoperatively, Fibromyalgia patient, Chronic taking of analgesic or anti-inflammatory medications during the preoperative period, namely taking at least daily for more than 4 weeks, Patient with a history of orthopedic surgery of the upper limb ipsilateral to the surgery, Patient with mechanical limitation of the joint range of the upper limb ipsilateral to surgery, Non-French speaking patient, Pregnant woman, Patient under 18-year-old, Patient whose BMI is greater than or equal to 35 kg / m2 Glomerular filtration rate less than <50 ml / min

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 |
| --- | --- |
| Active Comparator: suspension group<br>Arm on the side operated at 90 ° abduction, 90 ° anti-drive, resting on an arm support. | Other: positioning<br>* different positioning prior surgery<br>|
| Experimental: supported group<br>Arm on the operated side at 0 ° abduction, 90 ° anti-pulsation, resting on an adjustable support arm support located opposite the patient's head. | Other: positioning<br>* different positioning prior surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| post thoracoscopy shoulder pain measured on the Visual Pain Scale | postoperative shoulder pain measured on the Visual Pain Scale, its precise location on the patient's body will also be assessed | from the recovery unit to post-operative day 2 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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VATS, shoulder pain, pulmonary resection