[Anesthesia in surgical treatment of pyo-necrotic forms of diabetic foot].

Examinations of 48 patients with the syndrome of "diabetic foot" (IV-V degree according to Wagner classification), have shown advantages of prolonged epidural anesthesia (EA) carried out during pre-, intra-, and postoperative (6-7 days) period. This method has relieved pain during postoperative period with minimal impact on carbohydrate metabolism and central hemodynamics. Moreover prolonged EA is a basic prophylactic method against the development of phantom painful syndrome in patients with amputated extremity. The prolonged postoperative EA is a reliable method for modification of surgical stress-response, being especially important in patient, afflicted with a severe form of diabetes mellitus who represent a high surgical and anesthesiological risk group.