Effect of Modified Arm Positioning on Shoulder Pain After Thoracoscopic Lobectomy

NCT07746323 | Recruiting

• 1 other identifier: 2025（693）
• Study Type: interventional
• Target: 270
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Ipsilateral Shoulder Pain; Lung Neoplasms

Outcome Measures

Primary Outcomes (1)

• Incidence of Ipsilateral Shoulder Pain Within 24 Hours Postoperatively

  Within the first 24 hours after surgery

Secondary Outcomes (8)

• Incidence of Contralateral Shoulder Pain Within 24 Hours Postoperatively

  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.

  At 24 hours postoperatively

• incidence of ipsilateral shoulder pain at postoperative day 3

  Postoperative Day 3

• Positioning Setup Time

  Intraoperative recording

• Total Surgical Duration

  Intraoperative recording

Study Arms (2)

Traditional Arm-Board Position

ACTIVE COMPARATOR

Other: Traditional Arm-Board Position

Modified Bilateral Arm-Wrapping Position

EXPERIMENTAL

Other: Modified Double-Arm Wrap Positioning

Interventions

Modified Double-Arm Wrap Positioning OTHER

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.

Modified Bilateral Arm-Wrapping Position

Traditional Arm-Board Position OTHER

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.

Traditional Arm-Board Position

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

• Severe cervical spine disease or history of brachial plexus injury.
• Cognitive impairment or psychiatric disorder precluding understanding of pain assessment scales.

Sponsors & Collaborators

• Chengdu Jinjiang Maternity and Child Health Hospital: lead

Study Sites (1)

Chengdu Shangjin Nanfu Hospita

Chengdu, Sichuan, 610011, China

RECRUITING

MeSH Terms

Conditions

Lung Neoplasms

Condition Hierarchy (Ancestors)

Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases

Central Study Contacts

LU FENG

CONTACT

+86 15982012545; fengluhx@163.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director of Anesthesiology Department

Study Record Dates

• First Submitted: July 22, 2026
• First Posted: August 5, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): September 30, 2026
• Last Updated: August 5, 2026

Record last verified: 2026-07

Locations

CN (1)