Effect of Modified Arm Positioning on Shoulder Pain After Thoracoscopic Lobectomy

July 31, 2026 updated by: Fei Jia, Chengdu Jinjiang Maternity and Child Health Hospital

Effect of Modified Bilateral Arm Wrapping Position on Postoperative Ipsilateral Shoulder Pain in Patients Undergoing Video-Assisted Thoracoscopic Lobectomy: A Prospective Randomized Controlled Trial

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.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

270

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • China
    • Sichuan
      • Chengdu, Sichuan, China, 610011
        • Recruiting
        • Chengdu Shangjin Nanfu Hospita
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Age ≥18 years.
  2. Diagnosed with pulmonary space-occupying lesion and scheduled for elective video-assisted thoracoscopic standard lobectomy.
  3. ASA physical status classification I-III.
  4. No pre-existing shoulder pain or shoulder mobility impairment prior to surgery.
  5. No long-term use of analgesic medications (>1 week) before surgery.
  6. Willing and able to provide written informed consent.

Exclusion Criteria:

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Traditional Arm-Board Position
Other: Traditional Arm-Board Position
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.
Experimental: Modified Bilateral Arm-Wrapping Position
Other: Modified Double-Arm Wrap Positioning
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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Incidence of Ipsilateral Shoulder Pain Within 24 Hours Postoperatively
Time Frame: Within the first 24 hours after surgery
Within the first 24 hours after surgery

Secondary Outcome Measures

Outcome Measure
Time Frame
Incidence of Contralateral Shoulder Pain Within 24 Hours Postoperatively
Time Frame: Within the first 24 hours after surgery (Postoperative Day 1, 0-24 hours)
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.
Time Frame: At 24 hours postoperatively
At 24 hours postoperatively
incidence of ipsilateral shoulder pain at postoperative day 3
Time Frame: Postoperative Day 3
Postoperative Day 3
Positioning Setup Time
Time Frame: Intraoperative recording
Intraoperative recording
Total Surgical Duration
Time Frame: Intraoperative recording
Intraoperative recording
Postoperative Hospital Stay
Time Frame: At hospital discharge
At hospital discharge
Incidence of Brachial Plexus Injury-Related Signs Within 72 Hours Postoperatively
Time Frame: Within 72 hours postoperatively
Within 72 hours postoperatively
Position-related pressure injury within 72 h
Time Frame: From the end of surgery to 72 hours postoperatively
From the end of surgery to 72 hours postoperatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Chengdu Jinjiang Maternity and Child Health Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2026

Primary Completion (Estimated)

August 31, 2026

Study Completion (Estimated)

September 30, 2026

Study Registration Dates

First Submitted

July 22, 2026

First Submitted That Met QC Criteria

July 31, 2026

First Posted (Actual)

August 5, 2026

Study Record Updates

Last Update Posted (Actual)

August 5, 2026

Last Update Submitted That Met QC Criteria

July 31, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025（693）

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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