Objective: To determine the incidence, extent and site of saphenous neuralg
ia (anaesthesia, hyperaesthesia and pain) in the lower Limb after harvestin
g of great saphenous vein (GSV) for coronary artery bypass grafting (CABG).
Methods: Thirty-two consecutive patients (39 lower limbs) aged 58 +/- 16 y
ears undergoing CABG were prospectively reviewed. All patients were assesse
d pre-operatively to establish the presence of normal sensation, then at 3
days, 6 weeks and 20 +/- 4 months post-operatively for symptoms or signs of
saphenous neuralgia. The data were recorded on serial diagrammatic represe
ntations, and the area of sensory loss for each site was recorded at each r
eview. The decrease in areas of sensory loss over time was investigated wit
h statistical analysis. Results: Thirty-five (90%) of the lower limbs exami
ned showed some degree of anaesthesia at 3 days with 23 (72%) still symptom
atic at a mean follow up of 20 months. Hyperaesthesia and pain were infrequ
ently noted. Anaesthesia was generally confined to three main areas, which
were denoted sites A, B and C for descriptive purposes. The mean area of se
nsory loss in the lower limb at 3 days post-surgery was 53.4 cm(2), for an
incision of mean length 42 +/- 22 cm from the medial malleolus. This area r
educed to 31.7 cm(2) by 20 months, and the decrease in area over time for e
ach site was found to be statistically significant using analysis of varian
ce for repeated measures and the Freidman-Rubin test. Conclusions: This stu
dy demonstrates that saphenous neuralgia after harvest of GSV for CABG is c
ommon. The main symptom is anaesthesia and certain areas may persist for so
me considerable time post-operatively. (C) 1999 Published by Elsevier Scien
ce B.V. All rights reserved.