Anesthetic management of surgical interventions in patients with diabetic foot syndrome

Authors

  • R. V. Filimonov State Institution “Zaporizhzhia Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine”, Zaporizhzhia, Ukraine,
  • I. V. Filimonova State Institution “Zaporizhzhia Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine”, Zaporizhzhia, Ukraine,
  • Yu. Yu. Kobeliatskyi Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine, Dnipro, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2019.5.179471

Keywords:

review, regional anesthesia, diabetes mellitus, diabetes foot

Abstract

 

Objective. To study the issues of anesthetic management of surgical interventions in patients with diabetic foot syndrome.

In our work, the analysis of specialized literature and research on the anesthetic management of surgical interventions in patients with diabetic foot syndrome was performed. Most often diabetic foot syndrome (DFS) occurs in patients with severe diabetes and co-morbidities, and there are strict requirements for anesthesia safety for surgical interventions in DFS patients and minimal impact on carbohydrate metabolism and CNS functions. The results of the literature review have shown that preference is given to the regional methods of anesthesia as they allow patients to maintain a dietary pattern and insulin regimen, to reduce the risk of intraoperative complications in concomitant coronary artery disease, heart failure, cardiac arrhythmias, hypertension, renal failure, and pulmonary embolism incidence. Taking the above into account as well as cost-effectiveness and availability of modern navigation tools (for example, USD) for regional anesthesia performing, make it the most appropriate when choosing anesthesia technique in DFS patients.

Conclusions. An improvement of the treatment effectiveness as a whole and patient’s long-term quality of life must be taken into consideration when choosing an anesthesia method. Based on foreign and domestic studies, it can be argued that regional anesthesia is very beneficial and best for anesthesiologists and surgeons and, above all, for patients with DFS.

 

References

Abdullaev, R. Ya. Mammadov, I. G., & Abdullaev, R. R. (2015) Ul'trazvukovaya kharakteristika gryzh mezhpozvonkovykh diskov poyasnichnogo otdela u detej starshego vozrasta [Ultrasound characterization of hernias of lumbar intervertebral discs in older children]. Radiolohichnyi visnyk, 1–2, 9–12. [in Russian].

Bazheev, P. D., Avseenko, N. D., Tuktarova, D. R., & Chukhno, V. S. (2016) Vliyanie regionarnoj anestezii na dinamiku pokazatelej sistemy gemostaza sovremennye problemy anesteziologii-reanimatologii [The impact of regional anesthesia on the dynamics of hemostasis system indicators current problems of anesthesiology and resuscitation]. Materialy Vserossijskoj nauchnoprakticheskoj konferencii (Chitinskaya gosudarstvennaya meditsinskaya akademiya). Chita. [in Russian].

Garmish, O. S., Fomchenko, K. A., Zabashny, S. I., Molchanov, R. N., & Kobelyatskyi, Yu. Yu. (2016) Vozmozhnosti regionarnoj anestezii pri radikal'noj ciste'ktomii u bol'nykh myshechno-invazivnym rakom mochevogo puzyrya [The use of regional anesthesia in radical cystectomy in muscle-invasive bladder cancer patiens]. Medicina neotlozhnykh sostoyanij, 2(73), 79–85. [in Russian].

Gajsin, R. R., Panteleev, A. V., & Shatalov, V. I. (2016) Ocenka razlichij temperaturnoj i sensornoj blokady pri spinal'noj anestezii u travmatologicheskikh pacientov [Assessment of differences in temperature and sensory blockade during spinal anesthesia in trauma patients]. Novaya nauka: opyt, tradicii, innovacii (Mezhdunarodnoe nauchnoe periodicheskoe izdanie po itogam Mezhdunarodnoj nauchno-prakticheskoj konferenciyi), (Vol. 3), (P. 69–71). Omsk. [in Russian].

Dzyubanovsky, I. Ya., & Kritsak, M. Yu. (2014) Vybir metodu znebolennia u khvorykh iz uskladnenniamy diabetychnoi stopy [Selection of anesthesia method for patients with diabetic foot complications]. Shpytalna khirurhiia, 3, 67–68. [in Ukrainian].

Kobeliatskyi, Yu. Yu., & Shaida, Î. O. (2015) Suchasni metody obiеktyvizatsii boli ta notsitseptsii [Up-to-date technologies reflecting pain and nociception]. Medicina neotlozhnykh sostoyanij, 2(65), 19–23. [in Ukrainian].

Kurochkin, M. Yu. (2015) Otsiniuvannia efektyvnosti kaudalno-epiduralnoi anestezii shliakhom vymiriuvannia shkirnoi temperatury stop u ditei [Evaluation of caudal epidural anesthesia effi cacy by measurement of feet skin temperature in children]. Zaporozhye medical journal, 2(89), 83–85. [in Ukrainian]. doi: https://doi.org/10.14739/2310-1210.2015.2.42118

Lakhin, R. E., Schegolev, A. V., Panov, V. A., & Kuligin, A. V. (2015) Maloob''emnaya spinalnaya anesteziya pri artroskopii kolennogo sustava [Low dose spinal anesthesia for knee arthroscopy]. Saratovskij nauchno-medicinskij zhurnal, 11(2), 126–128. [in Russian].

Lyuboshevskij, P. A., & Ovechkin, A. M. (2014) Vozmozhnosti ocenki i korrekcii khirurgicheskogo stress-otveta pri operaciyakh vysokoj travmatichnosti [Possibilities for evaluating and correcting surgical stress response in highly traumatic operations]. Regionarnaya anesteziya i lecheniye ostroj boli, 8(4), 5–12. [in Russian].

Nedzveckij, S. V., Rudnov, V. A., & Tarasov, A. N. (2015) Perifericheskie nejroaksial'nye blokady pri operaciyakh na nizhnikh konechnostyakh [Peripheral neuroaxial blockade in operations on the lower limbs]. Vestnik anesteziologii i reanimatologii, 9(3), 55–60. [in Russian].

Orudzheva, S. A., & Zvyagin, A. A. (2015) Osobennosti i vozmozhnosti anesteziologicheskogo obespecheniya pri khirurgicheskom lechenii sindroma diabeticheskoj stopy [Particularities and possibilities of anesthetic management during surgical treatment of diabetic foot]. Regionarnaya anesteziya i lechenie ostroj boli, IX(1), 14–25. [in Russian].

Savinov, I. S., Il'chenko, F. N., Butyrskij, A. G., Savinov, S. G., & Kalachyov, E. V. (2016) Sravnitel'naya ocenka metodov i parametrov anestezii pri khirurgicheskom lechenii varikoznoj bolezni s khronicheskoj venoznoj nedostatochnost'yu klinicheskikh klassov C4–C6 [Comparative evaluation of methods and parameters of anesthesia in the surgical treatment of varicose veins with chronic venous insufficiency]. Tavricheskij mediko-biologicheskij vestnik, 19(3), 89–93. [in Russian].

Sofilkanych, M. M. (2015) Udoskonalennia khirurhichnoho ta kompleksnoho likuvannia khvorykh z hniino-nekrotychnymy uskladnenniamy stopy diabetyka (Dis…kand. med. nauk). [Improvement of surgical and complex treatment of patients with purulent-necrotic complications of the diabetic foot. Dr. med. sci. diss.]. Zaporizhzhia. [in Ukrainian].

Fomin, I. V., & Gratchev, S. S. (2013) Primenenie malykh doz mestnykh anestetikov pri anesteziologicheskom obespechenii planovykh ortopedicheskikh vmeshatel'stv [Small doses of local anaesthetics application in elective orthopedic surgery anesthesia]. Medicinskij zhurnal, 2, 118–120. [in Russian].

Shapovalov, A. A. (2016) Klinicheskaya e'ffektivnost' blokady sedalischnogo nerva lateral'nym dostupom pri osteosinteze perelomov goleni i stopy [The clinical efficacy of sciatic nerve block by lateral approach for the osteosynthesis of fractures leg and foot]. Travmotologiya i ortopediya Rossii, 22(1), 96–98. [in Russian].

Bathari, R., Bhalotra, A. R., Anand, R., & Kumar, V. (2015) A randomised trial to compare the effect of addition of clonidine or fentanyl to hyperbaric ropivacaine for spinal anaesthesia for knee arthroscopy. African Journal of Anaesthesia and Analgesia. 14–18. http://dx.doi.org/10.1080/22201181.2015.1089667

Wang, X., Chen, G. Y., Yang, S. S., Tian, Y., Ge, T., Qin, H., et al. (2014) Effects of high thoracic epidural anesthesia on ischemic cardiomyopathy cardiac function and autonomic neural function. Genetics and Molecular Research., 13(3), 6813–6819. doi: 10.4238/2014.August.29.2

Tomak, Y., Erdivanli, B., Sen, A., Bostan, H., Budak, E. T., & Pergel, A. (2016) Effect of cooled hyperbaric bupivacaine on unilateral spinal anesthesia success rate and hemodynamic complications in inguinal hernia surgery. Journal of Anestesia, 30(1), 26–30. doi: 10.1007/s00540-015-2081-1

Farag, E., Atim, A., Ghosh, R., Bauer, M., Sreenivasalu, T., Kot, M., et al. (2014) Comparison of three techniques for ultrasound-guided femoral nerve catheter insertion: a randomized, blinded trial. Anesthesiology, 121(2), 239–48. doi: 10.1097/ALN.0000000000000262

Gasser, H. S., & Erlanger, J (1929) Role of size in establishment of nerve block by pressure or cocaine. Am J Physiol, 88, Р. 581–589.

Koller K. (1884) Vorlaeufige Mitteilung ueber lokale Anaesthesierung am Auge. Berichte Dtsch Ophthalm. Ges., 60–63.

Witkin, L. R., Gulati, A., Zhang, T., & Karl, H. W. (2016) Lateral Femoral Cutaneous Nerve Entrapment. Peripheral Nerve Entrapments, 667–681.

Johnson, R. L., Kopp, S. L., Burkle, C. M., Duncan, C. M., Jacob, A. K., Erwin, P. J., et al. (2016) Neuraxial vs general anaesthesia for total hip and total knee arthroplasty: a systematic review of comparative-effectiveness research. Br J Anaesth., 116(2), 163–176. doi: 10.1093/bja/aev455

Wang, J., Liu, G. T., Mayo, H. G., & Joshi, G. P. (2015) Pain management for elective foot and ankle surgery: a systematic review of randomized controlled trials. The Journal of Foot and Ankle Surgere, 54(4), 625–35. doi: 10.1053/j.jfas.2014.05.003

Sanatkar, M., Sadeghi, M., Esmaeili, N., Sadrossadat, H., Shoroughi, M., Ghazizadeh, S., et al. (2013) The hemodynamic effects of spinal block with low dose of bupivacaine and sufentanil in patients with low myocardial ejection fraction. Acta Med Iran., 7(51), 438–443.

Neal, J. M., Barrington, M. J., Brull, R., Hadzic, A., Hebl, J. R., Horlocker, T. T., et al. (2015) The second ASRA practice advisory on neurologic complications associated with regional anesthesia and pain medicine: executive summary 2015. Regional Anesthesia & Pain Medicine, 40(5), 401–430. doi: 10.1097/AAP.0000000000000286

Nicholls, B., Kapral, S., & Marhofer, P. (2016) The use of ultrasound to aid local anesthetic nerve blocks in adults. Cambridge university press., 167–192.

van der Wal, S. E., van den Heuvel, S. A., Radema, S. A., van Berkum, B. F., Vaneker, M., Steegers, M. A., et al. (2016) The in vitro mechanisms and in vivo efficacy of intravenous lidocaine on the neuroinflammatory response in acute and chronic pain: a review of current. European jornal of pain., 20(5), 655–674. doi: 10.1002/ejp.794

Vandebroek, A., Vertommen, M., Huyghe, M., & Van Houwe, P. (2014) Ultrasound guided femoral nerve block and lateral femoral cutaneous nerve block for postoperative pain control after primary hip arthroplasty: a retrospective study. Acta Anaesth. Belg., Acta Anaesth. Belg..

Guerra Hernández, E. C. (2014) Uso profiláctico de ventilación mecánica no invasiva en cirugía de resección pulmonar. Departamento de Ciencias Médicas y Quirúrgicas.

Bendtsen, T. F., Haskins, S., Kølsen Petersen, J. A., & Børglum, J. (2016) Do ultrasound-guided regional blocks signify a new paradigm in high-risk patients? Best Practice & Research Clinical Anaesthesiology, 30(2), 191–200. doi: 10.1016/j.bpa.2016.04.004

How to Cite

1.
Filimonov RV, Filimonova IV, Kobeliatskyi YY. Anesthetic management of surgical interventions in patients with diabetic foot syndrome. Zaporozhye Medical Journal [Internet]. 2019Oct.1 [cited 2024Jun.22];(5). Available from: http://zmj.zsmu.edu.ua/article/view/179471

Issue

Section

Review