SUMMARY
To date, there is no consensus on the ideal method of anesthesia and analgesia in the perioperative period in patients with diabetic foot syndrome and lower extremity critical limb ishemia. However, regional anesthesia and peripheral nerve block methods have the greatest advantages.
Keywords: general anesthesia, regional anesthesia, diabetic foot, perifericnevral block

---

REFERENCES

1. Атлас диабета IDF, 9-е издание. Брюссель: Международная федерация диабета ‒ 2019.
2. Ayad S, Khanna AK, Iqbal SU, Singla N. Characterisation and monitoring of postoperative respiratory depression: current approaches and future considerations // Br J Anaesth. 2019 Sep;123(3):378-391. doi: 10.1016/j.bja.2019.05.044.
3. Бардюгов П.С., Паршиков М.В., Галстян Г.Р., Ярыгин Н.В. Показания к различным вариантам ортопедической коррекции деформаций стопы при диабетической нейроостеоартропатии // Сахарный диабет. 2020; 234: 374-385. doi: 10.18019/1028-4427-2022-28-3-452-458.
4. Weingarten TN, Jacob AK, Njathi CW, Wilson GA, et al. Multimodal Analgesic Protocol and Postanesthesia Respiratory Depression During Phase I Recovery After Total Joint Arthroplasty // Reg Anesth Pain Med. 2015 Jul-Aug;40(4):330-6. doi: 10.1097/AAP.0000000000000257.
5. De Jong A, Molinari N, Pouzeratte Y, Verzilli D, et al. Difficult intubation in obese patients: incidence, risk factors, and complications in the operating theatre and in intensive care units // Br J Anaesth. 2015 Feb;114(2):297-306. doi: 10.1093/bja/aeu373.
6. Zaidi SO, Khan Y, Razak BS, Malik BH. Insight Into the Perioperative Management of Type 2 Diabetes // Cureus. 2020 Feb 4;12(2):e6878. doi: 10.7759/cureus.6878.
7. Krishnasamy S, Abell TL. Diabetic Gastroparesis: Principles and Current Trends in Management // Diabetes Ther. 2018 Jul;9(Suppl 1):1-42. doi: 10.1007/s13300-018-0454-9.
8. Lai HY, Foo LL, Lim SM, Yong CF, Loh PS, Chaw SH, Hasan MS, Wang CY. The hemodynamic and pain impact of peripheral nerve block versus spinal anesthesia in diabetic patients undergoing diabetic foot surgery // Clin Auton Res. 2020 Feb;30(1):53-60. doi: 10.1007/s10286-017-0485-8.
9. Lavery LA, Oz OK, Bhavan K, Wukich DK. Diabetic Foot Syndrome in the Twenty-First Century // Clin Podiatr Med Surg. 2019 Jul;36(3):355-359. doi: 10.1016/j.cpm.2019.02.002.
10. Li J, Halaszynski T. Neuraxial and peripheral nerve blocks in patients taking anticoagulant or thromboprophylactic drugs: challenges and solutions // Local Reg Anesth. 2015 Aug 4;8:21-32. doi: 10.2147/LRA.S55306.
11. Levy N, Lirk P. Regional anaesthesia in patients with diabetes // Anaesthesia. 2021 Jan;76 Suppl 1:127-135. doi: 10.1111/anae.
12. Lin C, Liu J, Sun H. Risk factors for lower extremity amputation in patients with diabetic foot ulcers: A meta-analysis // PLoS One. 2020 Sep 16;15(9):e0239236. doi: 10.1371/journal. pone.0239236.
13. Lovic D, Piperidou A, Zografou I. et al.The Growing Epidemic of Diabetes Mellitus // Curr Vasc Pharmacol. 2020;18(2):104-109. doi: 10.2174/1570161117666190405165911.
14. Малышев Ю.П., Заболотских И.Б., Лебединский К.М. и др. Периоперационное ведение больных с сопутствующими эндокринными заболеваниями // Вестник интенсивной терапии, 2016г., №4, с. 41-51 Проект клинических рекомендаций.
15. Мискович А., Ламб А.Б. Послеоперационные легочные осложнения // Британский журнал анестезии, 2017;118:317–334. doi: 10.1093/bja/aex002.
16. Оруджева С.А., Завягин А.А. Особенности и возможности анестезиологического обеспечения при хирургическом лечении синдрома диабетической стопы // Регионарная анестезия и лечение острой боли. - 2015. - Т. 9. - №1. - C. 14-25.doi:10.17816/RA36229
17. Сен К.К. Человеческие раны и их бремя: обновленный сборник оценок 2020 г. Adv Wound care. 2021;10(5):281–92. doi: 10.1089/wound.2021.0026
18. Stevanovic K, Sabljak V, Toskovic A, Kukic B, et al. Anaesthesia and the patient with diabetes // Diabetes Metab Syndr. 2015 Jul-Sep;9(3):177-9. doi: 10.1016/j.dsx.2015.04.001
19. Francia P, Anichini R, Seghieri G, De Bellis A, et al. History, Prevalence and Assessment of Limited Joint Mobility, from Stiff Hand Syndrome to Diabetic Foot Ulcer Prevention: A Narrative Review of the Literature // Curr Diabetes Rev. 2018;14(5):411-426. doi: 10.2174/1573399813666170816142731
20. Ashken T, West S. Regional anaesthesia in patients at risk of bleeding // BJA Educ. 2021 Mar;21(3):84-94. doi: 10.1016/j.bjae.2020.11.004
21. Crowley K, Scanaill PÓ, Hermanides J, Buggy DJ. Current practice in the perioperative management of patients with diabetes mellitus: a narrative review // Br J Anaesth. 2023 Aug;131(2):242-252. doi: 10.1016/j.bja.2023.02.039
22. Zhu G, Xu J, Dai H, Min D, et al. Effect of peripheral nerve block versus general anesthesia on the hemodynamics and prognosis of diabetic patients undergoing diabetic foot Surgery // Diabetol Metab Syndr. 2023 Oct 26;15(1):213. doi: 10.1186/s13098-023-01185-9