title: Local anesthesia for surgery on the foot: efficacy in the ischemic or diabetic extremity.
abstract: The efficacy, risks, and benefits of the use of local anesthesia for surgery on the foot were assessed in 75 patients who underwent 127 procedures with lower calf, ankle, metatarsal-ray, and digital blocks. There were 23 procedures on digits alone, 97 forefoot operations (transmetatarsal amputations, wound debridements, closures, osteotomies, joint resections), six ankle or hind-foot amputations, and one open ankle disarticulation. There were no complications directly related to the use of local anesthesia; specifically, no extension of preexisting infection or ischemia due to injection in the foot. There were three deaths (30-day mortality 4%). The procedures were uniformly well tolerated, even in patients with ongoing myocardial ischemia or severe metabolic disorders. Local anesthesia is a safe and effective method to perform local debridement or amputation of the foot in an ischemic or diabetic extremity.
authors.affiliation: Department of Surgery, Albany Veterans Affairs Medical Center, New York.
authors.forename: J L
authors.initials: JL
authors.lastname: Kaufman
authors.forename: K
authors.initials: K
authors.lastname: Stark
authors.forename: D M
authors.initials: DM
authors.lastname: Shah
authors.forename: B B
authors.initials: BB
authors.lastname: Chang
authors.forename: A R
authors.initials: AR
authors.lastname: Koslow
authors.forename: R P
authors.initials: RP
authors.lastname: Leather
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000772:Anesthesia, Local; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000601:surgery; D005528:Foot / Q000098:blood supply* / Q000601:surgery; D005534:Foot Diseases / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000150:complications* / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies