SLR - June 2019 - Kevin P. Patel

A Prospective Comparison of Wide-Awake Local Anesthesia and General Anesthesia for Forefoot Surgery

Reference: Wright J, MacNeill L, Mayich J. A Prospective Comparison of Wide-Awake Local Anesthesia and General Anesthesia for Forefoot Surgery. Foot Ankle Surg, 25 (2019), pp. 211–214.

Scientific Literature Review

Reviewed By: Kevin P. Patel, DPM
Residency Program: Temple University Hospital, Philadelphia, PA

Podiatric Relevance: Many cardiac and respiratory complications are associated with different levels of anesthesia. It is important to know which type of anesthesia (local anesthesia versus general) would be beneficial to the patient surgically and clinically. The authors of this article would like to address the question of which is superior (local versus general anesthesia) in terms of anxiety or pain in forefoot surgery.

Methods: This was a retrospective case series that looked at 40 patients who underwent forefoot surgery using wide-awake anesthesia versus general anesthesia. Perioperative pain and anxiety outcome scores were measured, and ratings were collected on the day of surgery using a 0–10 numerical scale. Ratings were obtained during preoperative, intraoperative and postoperative phases.

Results: There were no differences noted between the two groups in terms of preoperative pain or anxiety. Patients who underwent wide-awake local anesthesia had lower levels of postoperative pain and anxiety compared to general anesthesia. They also reported minimal pain during the operation.

Conclusion: The authors concluded that wide-awake anesthesia is similar to general anesthesia without the significant complications associated with it. Therefore, it is important to consider the use of local anesthesia for forefoot surgery.

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