DISCUSSED PROBLEMS OF USING LOCAL ANESTHETICS FOR ULTRASOUND-DIAGNOSED EDEMA

Abstract

Regional methods of anesthesia are widely used in surgical interventions on the lower limb, in particular on the foot. Patients with diabetes are distinguished by high comorbidity, the diabetic foot often includes swelling of varying degrees of severity. As part of the hypothesis, it is necessary to answer the following questions: Does peri-neural edema of the subcutaneous fatty tissue reduce the effectiveness of local anesthet-ics? If so! Then, in what way? Which factor is decisive, the dilution in the edema vo-lume, or the pH of the edema fluid itself? The degree of dilution will depend on the volume of the swelling. Indeed, in this class of patients, during ultrasound examination, we observed various patterns of edema. Which obviously correspond to different degrees of swelling. But how to objectify them? An ultrasound image is a two-dimensional image, and fluid passages (edema) chaotically fill the space between fat lobes.