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  • Title: Local anesthesia for surgery on the foot: efficacy in the ischemic or diabetic extremity.
    Author: Kaufman JL, Stark K, Shah DM, Chang BB, Koslow AR, Leather RP.
    Journal: Ann Vasc Surg; 1991 Jul; 5(4):354-8. PubMed ID: 1878292.
    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.
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