{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:35:11Z","timestamp":1786649711984,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Background and Aims:<\/jats:title>\n Peripheral arterial disease (PAD) impairs blood flow to the extremities, leading to symptoms that impair quality of life (QOL). Lumbar sympathectomy (LS) has shown potential in symptom management, particularly in cases where medical therapy or vascular bypass surgery fails. However, limited evidence compares the efficacy of LS in patients with and without prior vascular bypass surgery. This study evaluates the differential impact of LS on pain relief, analgesic consumption, and QOL in these subgroups.<\/jats:p>\n <\/jats:sec>\n \n Material and Methods:<\/jats:title>\n \n A retrospective observational study was conducted involving 34 PAD patients who underwent fluoroscopy-guided LS between September 2023 and June 2024. Patients without prior vascular bypass surgery (Group L,\n n<\/jats:italic>\n = 17) and with prior vascular bypass surgery (Group LB,\n n<\/jats:italic>\n = 17) were assessed for pain using the Visual Analog Scale (VAS), analgesic consumption with the Overall Benefit of Analgesic Score (OBAS), and QOL via World Health Organization Quality of Life Brief Version (WHOQOL-BREF). OBAS is a 7-item patient self-report instrument that combines pain severity, opioid side effects, and treatment satisfaction in the past 24 h. We examined the sum of all WHOQOL-BREF items as the prespecified QOL measure (26 items; higher scores = better QOL). The four domains (Physical, Psychological, Social Relationships, and Environment) were not examined individually in the primary analysis to prevent multiplicity and because of the small sample size; results at the domain level, if examined, were considered exploratory and are not inferentially contrasted. Analysis of data was performed with descriptive statistics, paired and independent\n t<\/jats:italic>\n -tests, Welch\u2019s\n t<\/jats:italic>\n -tests, standardized effect sizes (Hedges\u2019 g and Cohen\u2019s dz), and repeated-measures Analysis of Variance test analysis of variance (ANOVA) with Greenhouse\u2013Geisser correction; statistical significance was at\n P<\/jats:italic>\n < 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Both groups showed significant improvements in VAS, OBAS, and QOL (\n P<\/jats:italic>\n < 0.001). Patients in Group L experienced better immediate pain relief (VAS at 24 h: 3.29 vs. 4.29,\n P<\/jats:italic>\n = 0.001) and sustained OBAS benefits over three months (\n P<\/jats:italic>\n < 0.05). QOL improvements were comparable between groups in the long term.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n LS is effective in improving pain, reducing analgesic use, and enhancing QOL in PAD patients. Bypass-na\u00efve patients demonstrated better immediate outcomes, suggesting tailored therapeutic benefits. Prospective studies are needed to confirm these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/joacp.joacp_214_25","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T10:01:01Z","timestamp":1776679261000},"page":"366-372","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the effect of lumbar sympathectomy in patients with or without vascular bypass surgery: A retrospective observational study"],"prefix":"10.4103","volume":"42","author":[{"given":"Rhythm","family":"Mathur","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep K.","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Kamal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharat","family":"Paliwal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirudh","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"R1-20260626","doi-asserted-by":"crossref","first-page":"100095","DOI":"10.1016\/j.jvsvi.2024.100095","article-title":"Facing the challenges of peripheral arterial disease in the era of emerging technologies","volume":"2","author":"Hedhli","year":"2024","journal-title":"JVS Vasc Insights"},{"key":"R2-20260626","doi-asserted-by":"crossref","first-page":"100291","DOI":"10.1016\/j.ahjo.2023.100291","article-title":"Peripheral arterial disease: A small and large vessel problem","volume":"28","author":"Bethel","year":"2023","journal-title":"Am Heart J Plus Cardiol Res Pract"},{"key":"R3-20260626","doi-asserted-by":"crossref","first-page":"e009727","DOI":"10.1161\/CIRCINTERVENTIONS.120.009727","article-title":"Antiplatelet therapy following peripheral arterial interventions: The choice is yours","volume":"13","author":"Aday","year":"2020","journal-title":"Circ Cardiovasc Interv"},{"key":"R4-20260626","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1055\/s-0034-1393969","article-title":"Pharmacology in peripheral arterial disease: What the interventional radiologist needs to know","volume":"31","author":"Atturu","year":"2014","journal-title":"Semin Interv Radiol"},{"key":"R5-20260626","doi-asserted-by":"crossref","first-page":"185","DOI":"10.4103\/ijves.ijves_23_17","article-title":"Percutaneous chemical lumbar sympathectomy for Buerger's disease: Results in 147 patients","volume":"4","author":"Kothari","year":"2017","journal-title":"Indian J Vasc Endovasc Surg"},{"key":"R7-20260626","first-page":"188","article-title":"Effect of the lumbar sympathetic block on pain in patients with symptomatic peripheral arterial disease: Retrospective Analysis","volume":"30","author":"Kaya","year":"2022","journal-title":"J Anesth"},{"key":"R8-20260626","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.medcli.2009.09.039","article-title":"Effectiveness of lumbar sympathectomy in the treatment of occlusive peripheral vascular disease in lower limbs: Systematic review","volume":"134","author":"Ruiz-Arag\u00f3n","year":"2010","journal-title":"Med Clin (Barc)"},{"key":"R9-20260626","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s002709900268","article-title":"CT-guided lumbar sympathectomy: Results and analysis of factors influencing the outcome","volume":"21","author":"Heindel","year":"1998","journal-title":"Cardiovasc Intervent Radiol"},{"key":"R10-20260626","doi-asserted-by":"crossref","first-page":"682","DOI":"10.3390\/medicina60050682","article-title":"Retrospective evaluation of the effect of lumbar sympathetic blockade on pain scores, fontaine classification, and collateral perfusion status in patients with lower extremity peripheral arterial disease","volume":"60","author":"Keser-Pehlivan","year":"2024","journal-title":"Medicina (Kaunas)"},{"key":"R11-20260626","first-page":"CD009366","article-title":"Lumbar sympathectomy versus prostanoids for critical limb ischaemia due to non-reconstructable peripheral arterial disease","volume":"4","author":"Sen","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"R12-20260626","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/S0939-4753(04)80003-6","article-title":"Prostaglandin E1 versus lumbar sympathectomy in the treatment of peripheral arterial occlusive disease: Randomised study of 86 patients","volume":"14","author":"Petronella","year":"2004","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"R13-20260626","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1002\/bjs.1800720903","article-title":"Lumbar sympathectomy for arterial disease","volume":"72","author":"Cotton","year":"1985","journal-title":"Br J Surg"},{"key":"R14-20260626","doi-asserted-by":"crossref","first-page":"3066","DOI":"10.1007\/s00464-011-1671-8","article-title":"Retroperitoneoscopic lumbar sympathectomy: Prospective study upon a series of 50 consecutive patients","volume":"25","author":"Neme\u015f","year":"2011","journal-title":"Surg Endosc"},{"key":"R15-20260626","first-page":"CD011519","article-title":"Lumbar sympathectomy techniques for critical lower limb ischaemia due to non-reconstructable peripheral arterial disease","volume":"12","author":"Karanth","year":"2016","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Journal of Anaesthesiology Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_214_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:57:28Z","timestamp":1786647448000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_214_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/joacp.joacp_214_25","relation":{},"ISSN":["0970-9185","2231-2730"],"issn-type":[{"value":"0970-9185","type":"print"},{"value":"2231-2730","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]},"assertion":[{"value":"2025-04-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}