title: Risk Factors for Chronic Saphenous Neuralgia Following Coronary Artery Bypass Graft Surgery Utilizing Saphenous Vein Grafts.
abstract: OBJECTIVE
  The aim of this trial was to determine risk factors for chronic saphenous neuralgia (SN) following harvesting of the great saphenous vein (GSV) for coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  In a prospective observational trial, 526 patients with no history of chronic painful disorders or surgery in the lower limbs were followed up for 13 weeks after undergoing CABG surgery in which GSV grafts were used. The primary outcome measure was persistence of clinically significant pain of neuropathic type in the territory supplied by the saphenous nerve beyond 12 weeks after surgery.
  
  
  RESULTS
  Eighty-one (15.4%) patients consistently had probable neuropathic pain of clinically significant severity throughout the follow-up period and were labeled as suffering from chronic SN. Multivariable binary logistic regression analysis showed that younger age (OR, 0.92; 95% CI, 0.88-0.95; P-value, < 0.0001), female gender (OR, 2.28; 95% CI, 1.21-4.29; P-value, 0.011), higher body mass index (OR, 1.25; 95% CI, 1.17-1.35; P-value, < 0.0001), diabetes mellitus (OR, 2.13; 95% CI, 1.13-4.01; P-value, 0.020), distal-to-proximal dissection of the GSV (OR, 7.28; 95% CI, 3.62-14.66; P-value, < 0.0001), and closure of the leg wound in two layers (OR, 3.28; 95% CI, 1.81-5.95; P-value, 0.0001) were independent risk factors for chronic SN.
  
  
  CONCLUSIONS
  Chronic SN after CABG surgery utilizing GSV grafts is not uncommon. Risk factors identified in this trial are younger age, female gender, higher body mass index, diabetes mellitus, distal-to-proximal dissection of the GSV, and closure of the leg wound in two layers.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Sameh M
authors.initials: SM
authors.lastname: Hakim
authors.affiliation: Center for Pain Medicine, Summa Western Reserve Hospital, Cuyahoga Falls, Ohio, U.S.A.
authors.forename: Samer N
authors.initials: SN
authors.lastname: Narouze
mesh_terms: D000368:Aged; D002908:Chronic Disease; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000453:epidemiology* / Q000209:etiology*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*
keywords: complications; coronary bypass surgery; nerve pain; neuralgia; neuropathic pain; postoperative neuralgia; risk factors; saphenous neuralgia