Incidence and risk factors associated with ipsilateral shoulder pain after thoracic surgery.
OBJECTIVE
This study was designed to determine the incidence and risk factors associated with ipsilateral shoulder pain (ISP) after thoracic surgery and to investigate characteristics, locations, and severity of ISP.


METHODS
A prospective observational study.


METHODS
University hospital.


METHODS
Two hundred five patients who underwent thoracic surgery.


METHODS
None.


RESULTS
Pain at the incisional site and shoulder pain were assessed separately using the numeric rating scale (NRS) during the patients' stay in the postanesthesia care unit. The overall incidence of ISP was 47.3%. The incidence of ISP in thoracotomy patients (58.7%) was substantially higher than in video-assisted thoracoscopic surgery patients (20.9%). ISP was described most often as a dull aching pain (87%). In approximately half of the patients, ISP was located at the posterior side of the shoulder. The severity of ISP was classified as moderate to severe in 67% of patients. The potential risk factors associated with ISP were surgery using the thoracotomy approach (risk ratio: 2.12, 95% confidence interval: 1.16-3.86, p=0.014) and surgical duration>120 minutes (risk ratio: 1.61, 95% confidence interval: 1.07-2.44, p=0.023).


CONCLUSIONS
The incidence of ISP after thoracic surgery was high and the severity of pain was significant. The thoracotomy approach and the long duration of surgery are potential risk factors for ISP.
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. Electronic address: nutchb@gmail.com.
Nutchanart
N
Bunchungmongkol
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Tanyong
T
Pipanmekaporn
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Sahattaya
S
Paiboonworachat
Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Somcharoen
S
Saeteng
Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Apichat
A
Tantraworasin
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D011013:Pneumonectomy / Q000009:adverse effects*; D011446:Prospective Studies; D020069:Shoulder Pain / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D013785:Thailand / Q000453:epidemiology; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects*; D013908:Thoracotomy / Q000009:adverse effects*; D055815:Young Adult
shoulder pain; thoracic surgery; thoracoscopic surgery; thoracotomy; video-assisted