Journal of Foot and Ankle Surgery
Volume 49, Issue 2 , Pages 152-154, March 2010

Safety of Local Anesthesia Combined with Monitored Intravenous Sedation for American Society of Anesthesiologists 3 and 4 Patients Undergoing Lower Limb–preservation Procedures

  • Nalini Vadivelu, MD

      Affiliations

    • Associate Professor, Department of Anesthesiology, Yale University, New Haven, CT
    • Corresponding Author InformationAddress correspondence to: Nalini Vadivelu, MD, Associate Professor, Department of Anesthesiology, Yale University, New Haven, CT 06520.
    • ,
  • Michael Gesquire, MD

      Affiliations

    • Resident CA3, Department of Anesthesiology, Yale University, New Haven, CT
    • ,
  • Sukanya Mitra, MD

      Affiliations

    • Associate Professor of Anesthesia and Critical Care, Government Medical College & Hospital, Chandigarh, India
    • ,
  • Kirk Shelley, MD

      Affiliations

    • Professor, Department of Anesthesiology, Yale University, New Haven, CT
    • ,
  • Gopal Kodumudi

      Affiliations

    • Volunteer, Department of Anesthesiology, Yale University, New Haven, CT
    • ,
  • Yu Xia

      Affiliations

    • Yale College, Yale University, New Haven, CT
    • ,
  • Peter Blume, DPM

      Affiliations

    • Assistant Professor, Department of Podiatry and Orthopedics, Yale University, New Haven, CT

published online 05 February 2010.

Abstract 

The aim of this retrospective study is to evaluate the prognostic value of American Society of Anesthesiologists (ASA) classification with regard to perioperative variables of cardiac complications, pulmonary complications, and mortality in patients undergoing limb salvage procedures with monitored intravenous sedation and foot and ankle blocks. None of the ASA 3 or 4 patients experienced any pulmonary or cardiac complication; no patient required invasive monitoring or postoperative cardiac care unit admission. We suggest that the performance of peripheral foot and ankle blocks with monitored intravenous sedation appears to be a safe and useful option for ASA 3 and 4 patients undergoing limb-preservation surgery.

Level of Clinical Evidence: 2

Keywords: bupivacaine, diabetic foot infection, limb salvage, nerve block, physical status, surgical complication

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 Financial Disclosure: None reported.

 Conflict of Interest: None reported.

PII: S1067-2516(09)00421-9

doi:10.1053/j.jfas.2009.09.006

Journal of Foot and Ankle Surgery
Volume 49, Issue 2 , Pages 152-154, March 2010

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