Local anesthesia for surgery on the foot: efficacy in the ischemic or diabetic extremity

Ann Vasc Surg. 1991 Jul;5(4):354-8. doi: 10.1007/BF02015296.


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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amputation, Surgical
  • Anesthesia, Local*
  • Diabetes Complications*
  • Diabetes Mellitus / surgery
  • Foot / blood supply*
  • Foot / surgery
  • Foot Diseases / etiology*
  • Foot Diseases / surgery
  • Humans
  • Ischemia / complications*
  • Ischemia / surgery
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies