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

Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec

Status: Unknown

Conditions: Post-thoracotomy Pain Syndrome

Treatments: Other: positioning

Study type: Interventional

Funder types: Other

Identifiers

NCT04415242

2020-3430, 21919

Details and patient eligibility

About

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.

Full 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.

Enrollment: 134 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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134 participants in 2 patient groups

suspension group

Active Comparator group

Description:

Arm on the side operated at 90 ° abduction, 90 ° anti-drive, resting on an arm support.

Treatment:

Other: positioning

supported group

Experimental group

Description:

Arm on the operated side at 0 ° abduction, 90 ° anti-pulsation, resting on an adjustable support arm support located opposite the patient's head.

Treatment:

Other: positioning