Analysis of Risk Factors for Ipsilateral Shoulder Pain and Pain Intensity After Thoracic Surgery

This study aimed primarily to investigate the determinants of ipsilateral shoulder pain (ISP) and pain intensity in patients undergoing thoracic surgery.

Patients who were hospitalized in the Department of Thoracic Surgery of the Fifth Affiliated Hospital of Sun Yat-Sen University from February to December 2024 and met the inclusion and exclusion criteria.

Basic demographic information on all patients was retrieved from medical records, questionnaires were administered during the patient's hospitalization and the results were recorded, and the Hamilton Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index were assessed on admission and on the first postoperative day. Patients were assessed for the occurrence of ISP by the same examiner, and those with IPS were recorded using the Brief Pain Inventory.

A total of 204 eligible patients were included, and the incidence of ISP was 44.1%. Regression analysis showed that age group 41-60 years and segmentectomy were independent risk factors for ISP occurrence. The risk of postoperative ISP increased by 23.7% for each 1-point increase in postoperative anxiety scores. Elevated postoperative anxiety levels were significantly and positively associated with ISP pain scores, with each 1-point increase in anxiety score corresponding to an average increase of 0.158 points in pain intensity.

The high incidence of ISP after minimally invasive lung surgery warrants attention during the patient's postoperative rehabilitation. Middle age, segmentectomy, and anxiety were independent risk factors for ISP, and the level of anxiety was linearly and positively correlated with ISP pain scores.

Chinese Clinical Trial Registry: ChiCTR2500099002.