title: Neuropathic pain after femoropopliteal bypass surgery.
abstract: OBJECTIVE
  This retrospective study was performed to investigate prolonged postoperative pain in the area of the proximal or distal scar or the bypass tunnel after femoropopliteal bypass surgery to treat symptomatic peripheral arterial disease.
  
  
  METHODS
  Ninety-three patients with peripheral arterial disease who underwent femoropopliteal bypass surgery between January 2000 and December 2002 were included in the study. The short-form McGill Pain Questionnaire was used to score pain. Ultrasound examination of the soft tissue around the graft was performed to exclude other pathologic conditions responsible for pain, such as inflammatory processes, perigraft reactions, swollen lymph nodes, and hematomas.
  
  
  RESULTS
  Pain in at least one scar existed in 22 patients on average 13.9 +/- 9.8 months after surgery. In 10 patients pain existed simultaneously along the inguinal scar and the above-knee or below-knee scar. Pain along the bypass tunnel was experienced by seven patients. Most patients had mild to moderate pain. The mean numeric ranking score of pain severity in patients with pain was 4.2 +/- 2.3. The occurrence of prolonged postoperative pain was not associated with age, gender, diabetes, indication for surgery, material or type of bypass, number of preceding operations, or postoperative wound complications. Only follow-up time after femoropopliteal bypass surgery tended to be lower in patients with pain compared with those without pain.
  
  
  CONCLUSIONS
  Prolonged postoperative neuropathic pain along the distal and proximal incision or the bypass tunnel exists in one fourth of patients after femoropopliteal bypass surgery. Patients should be informed of this kind of complication before surgery. The results of our study justify further investigations of the origin and treatment of this pain, to find effective methods to reduce the incidence of prolonged postoperative pain after femoropopliteal bypass surgery.
authors.affiliation: Department of Vascular Surgery, Leopold Franzens University Hospital Innsbruck, Anichstrasse 35, A-1060 Innsbruck, Austria. andreas.greiner@uibk.ac.at
authors.forename: A
authors.initials: A
authors.lastname: Greiner
authors.forename: B
authors.initials: B
authors.lastname: Rantner
authors.forename: K
authors.initials: K
authors.lastname: Greiner
authors.forename: F
authors.initials: F
authors.lastname: Kronenberg
authors.forename: M
authors.initials: M
authors.lastname: Schocke
authors.forename: B
authors.initials: B
authors.lastname: Neuhauser
authors.forename: J
authors.initials: J
authors.lastname: Bodner
authors.forename: G
authors.initials: G
authors.lastname: Fraedrich
authors.forename: A
authors.initials: A
authors.lastname: Schlager
mesh_terms: D000368:Aged; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000000981:diagnostic imaging / Q000209:etiology*; D017933:Peripheral Nervous System / Q000000981:diagnostic imaging / Q000473:pathology*; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014656:Vascular Surgical Procedures / Q000009:adverse effects