Clinical trial NCT04415242: IMPACT OF OPERATIVE POSITIONING ON THE DEVELOPMENT OF SHOULDER PAIN AFTER PULMONARY LOBECTOMY BY VATS
Official title: IMPACT OF OPERATIVE POSITIONING ON THE DEVELOPMENT OF SHOULDER PAIN AFTER PULMONARY LOBECTOMY BY VATS
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Post-thoracotomy Pain Syndrome
Keywords: VATS
shoulder pain
pulmonary resection
Lead sponsor: Institut universitaire de cardiologie et de pneumologie de Québec, University Laval
Sponsor class: OTHER
First posted: 2020-06-04
Enrollment: 134
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: post thoracoscopy shoulder pain measured on the Visual Pain Scale
timeFrame: from the recovery unit to post-operative day 2
Secondary outcomes:
Other outcomes:
Locations:
city: Québec
country: Canada
facility: Institut Universitaire de Cardiologie et de pneumologie de Québec
state: Quebec
Study officials:
References:
citation: Ip HY, Abrishami A, Peng PW, Wong J, Chung F. Predictors of postoperative pain and analgesic consumption: a qualitative systematic review. Anesthesiology. 2009 Sep;111(3):657-77. doi: 10.1097/ALN.0b013e3181aae87a.
citation: Barak M, Ziser A, Katz Y. Thoracic epidural local anesthetics are ineffective in alleviating post-thoracotomy ipsilateral shoulder pain. J Cardiothorac Vasc Anesth. 2004 Aug;18(4):458-60. doi: 10.1053/j.jvca.2004.05.025.