Incidence and Risk Factors for Ipsilateral Shoulder Pain Following Thoracic Surgery

Background Ipsilateral shoulder pain (ISP) after thoracic surgery is often more difficult to control than incisional pain and may adversely affect postoperative quality of life (QOL). Objective This study aimed to determine the incidence of ISP after thoracic surgery and to identify factors associated with its occurrence. Methods We conducted a single-center, retrospective observational study including patients aged ≥20 years who underwent thoracic surgery in the lateral decubitus position between April 1, 2022, and March 31, 2024. Patients were classified into an ISP group and a non-ISP group, and perioperative variables were compared between groups. Results Of the 328 patients included in the analysis, 116 patients (35.4%) developed ipsilateral shoulder pain (ISP). Logistic regression analysis was performed for variables that showed statistically significant differences. In the univariate analysis, significant differences were observed in 10 variables: height, body mass index (BMI), disease, anesthesia time, operative time, time in the lateral decubitus position, surgical approach, type of surgery, use of epidural anesthesia, and use of postoperative analgesics. These 10 variables were included in the multivariate analysis, which demonstrated that the type of surgery (lobectomy and partial lung resection) and prolonged time in the lateral decubitus position (≥210 minutes) were independently associated with the occurrence of ISP. Conclusions The incidence of ISP after thoracic surgery was 35.4%. Prolonged lateral positioning and surgical type may increase the risk of ISP.