Unilateral Spinal Anesthesia as a Method of Anesthesia during Operations in Patients with Diabetic Foot Syndrome

The article shows a comparison of unilateral spinal anesthesia with traditional spinal anesthesia and block anesthesia of sciatic nerve during surgical interventions in patients with diabetic foot syndrome. It was discovered that unilateral spinal anesthesia in comparison with traditional spinal anesthesia significantly reduces desimpatisation area. As a result, it leads to hemodynamics stability and neutralizes problems with urination during the postoperative period. A similar effect is observed in case of the block anesthesia of sciatic nerve, but in some cases, it is rather difficult to conduct this kind of anesthesia. The purpose of the study was to assess the effectiveness of unilateral spinal anesthesia as a method of anesthesia during foot surgical interventions in patients with the diabetic foot syndrome. Materials and methods. We examined 96 patients with the diabetic foot syndrome, who received treatment in the department of purulent surgery. In the course of the study, we conducted the monitoring of cardio-vascular system indicators and Doppler scanning of peripheral blood flow in patients. Results and discussion. It was conclusively discovered (p<0,05) that ABP indicators and the level of improvement in foot peripheral microcirculation during unilateral spinal anesthesia are more stable than during traditional spinal anesthesia and block anesthesia of sciatic nerve. The operated extremity improved in all the study groups, after regional anesthesia, peripheral microcirculation. This fact was fixed by Doppler scan of peripheral blood flow performed with a portable audio indicator of the blood flow velocity "MINIOPE - 8" with a finger cuff on 1 finger of the foot and fixation blood flow indicators (systolic blood pressure) on the arteries of this finger. There was no significant difference between the 1st and 2nd group (p <0.05). Both these methods of RA had positive effect on the level microcirculation, which led to improvement of reparative processes in the operated limb. When comparing the 1st and 3rd group, it was reliably revealed (p <0.05) that the effect of unilateral spinal anesthesia on the level of peripheral microcirculation is more pronounced than with block anesthesia of sciatic nerve. Conclusions. Unilateral spinal anesthesia is the method of selection during foot operations in patients with diabetic foot syndrome.