{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:01Z","timestamp":1783509301517,"version":"3.55.0"},"reference-count":25,"publisher":"MDPI AG","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Lower-extremity amputation for a diabetic foot is mainly performed under general or central neuraxial anesthesia. Ultrasound-guided peripheral nerve block (PNB) can be a good alternative, especially for patients who require continuous anticoagulation treatment and patients with additional comorbidities. We evaluated bleeding due to PNB application in patients with diabetic foot receiving antiplatelet or anticoagulant therapy. Perioperative morbidity and mortality and the need for intensive care hospitalization were analyzed.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    This study included 105 patients with diabetic foot or debridement who underwent distal foot amputation or debridement between February and October 2020. Popliteal nerve block (17 mL of 5% bupivacaine and 3 mL of saline) and saphenous nerve block (5 mL of 2% lidocaine) were applied to the patients. Postoperative pain scores (at 4, 8, 12, and 24 hours) and complications due to PNB were evaluated. Intensive care admission and 1-month mortality were recorded.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The most common diseases accompanying diabetes were hypertension and peripheral artery disease. No complications due to PNB were observed. Mean \u00b1 SD postoperative first analgesic need was determined to be 14.1 \u00b1 4.1 hours. Except for one patient, this group was followed up without the need for postoperative intensive care. In 16 patients, bleeding occurred as leakage from the surgical area, and it was stopped with repeated pressure dressing. Mean \u00b1 SD patient satisfaction score was 8.36 \u00b1 1.59. Perioperative mortality was not observed.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Ultrasound-guided PNB can be an effective and safe anesthetic technique for diabetic patients undergoing distal foot amputation, especially those receiving antiplatelet or anticoagulant therapy and considered high risk.\n                  <\/jats:p>","DOI":"10.7547\/21-115","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T12:36:04Z","timestamp":1715862964000},"source":"Crossref","is-referenced-by-count":3,"title":["Effectiveness of Peripheral Nerve Block in Terms of Search for a Standardized Treatment Protocol in Diabetic Foot Patients Using Anticoagulants: A Double-Center Study"],"prefix":"10.3390","volume":"114","author":[{"given":"Derya","family":"Ozkan","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Reanimation, Diskapi Research and Training Hospital, University of Health Sciences, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Tugba","family":"Arslan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Reanimation, Diskapi Research and Training Hospital, University of Health Sciences, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Burak","family":"Eskin","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Reanimation, Gulhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma Ozkan","family":"Sipahioglu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Reanimation, Diskapi Research and Training Hospital, University of Health Sciences, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasemin","family":"Ermis","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Reanimation, Diskapi Research and Training Hospital, University of Health Sciences, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokhan","family":"Ozkan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Reanimation, Gulhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Diskapi Research and Training Hospital, University of Health Sciences, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burak","family":"Nalbant","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Reanimation, Diskapi Research and Training Hospital, University of Health Sciences, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Yuksel","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Diskapi Research and Training Hospital, University of Health Sciences, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerim Bora","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Diabetic Foot Clinic, Gulhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"Diabetes Metab Syndr","first-page":"1287","article-title":"Association of diabetic foot ulcers with chronic vascular diabetic complications in patients with type 2 diabetes","volume":"13","author":"Megallaa MH","year":"2019","unstructured":"Megallaa MH, Ismail AA, Zeitoun MH, et al: Association of diabetic foot ulcers with chronic vascular diabetic complications in patients with type 2 diabetes. Diabetes Metab Syndr 13: 1287, 2019."},{"key":"B2","series-title":"Curr Diab Rep","first-page":"86,","article-title":"Epidemiology of peripheral neuropathy and lower extremity disease in diabetes","volume":"19","author":"Hicks CW","year":"2019","unstructured":"Hicks CW, Selvin E: Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Curr Diab Rep 19: 86, 2019."},{"key":"B3","series-title":"J Cardiovasc Surg (Torino","first-page":"670,","article-title":"Diabetic foot management: multidisciplinary approach for advanced lesion rescue","volume":"59","author":"Brocco E","year":"2018","unstructured":"Brocco E, Ninkovic S, Marin M, et al: Diabetic foot management: multidisciplinary approach for advanced lesion rescue. J Cardiovasc Surg (Torino) 59: 670, 2018."},{"key":"B4","series-title":"Diabetes Obes Metab","first-page":"435","article-title":"Peripheral arterial disease and revascularization of the diabetic foot","volume":"17","author":"Forsythe RO","year":"2015","unstructured":"Forsythe RO, Brownrigg J, Hinchliffe RJ: Peripheral arterial disease and revascularization of the diabetic foot. Diabetes Obes Metab 17: 435, 2015."},{"key":"B5","series-title":"Am Fam Physician","first-page":"362","article-title":"Lower extremity peripheral artery disease: diagnosis and treatment","volume":"99","author":"Firnhaber JM","year":"2019","unstructured":"Firnhaber JM, Powell CS: Lower extremity peripheral artery disease: diagnosis and treatment. Am Fam Physician 99: 362, 2019."},{"key":"B6","series-title":"J Clin Anesth","first-page":"363","article-title":"Femoral and sciatic nerve block with 0.25% bupivacaine for surgical management of diabetic foot syndrome: an anesthetic technique for high-risk patients with diabetic nephropathy","volume":"22","author":"Kocum A","year":"2010","unstructured":"Kocum A, Turkoz A, Bozdogan N, et al: Femoral and sciatic nerve block with 0.25% bupivacaine for surgical management of diabetic foot syndrome: an anesthetic technique for high-risk patients with diabetic nephropathy. 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Semin Vasc Surg 31: 56, 2018."},{"key":"B10","series-title":"Vasc Endovasc Surg","first-page":"310","article-title":"Real-time quantitative measurements of foot perfusion in patients with critical limb ischemia","volume":"53","author":"Mironov O","year":"2019","unstructured":"Mironov O, Zener R, Eisenberg N, et al: Real-time quantitative measurements of foot perfusion in patients with critical limb ischemia. Vasc Endovasc Surg 53: 310, 2019."},{"key":"B11","series-title":"Reg Anesth Pain Med","first-page":"218","article-title":"Ultrasound-guided popliteal block through a common paraneural sheath versus conventional injection: a prospective, randomized, double-blind study","volume":"38","author":"Perlas A","year":"2013","unstructured":"Perlas A, Wong P, Abdallah F, et al: Ultrasound-guided popliteal block through a common paraneural sheath versus conventional injection: a prospective, randomized, double-blind study. Reg Anesth Pain Med 38: 218, 2013."},{"key":"B12","series-title":"Best Pract Res Clin Anaesthesiol","first-page":"79","article-title":"Ultrasound-guided ankle block: history revisited","volume":"33","author":"Delbos A","year":"2019","unstructured":"Delbos A, Philippe M, Cl\u00e9ment C, et al: Ultrasound-guided ankle block: history revisited. Best Pract Res Clin Anaesthesiol 33: 79, 2019."},{"key":"B13","series-title":"J Korean Med Sci","first-page":"e178,","article-title":"Trends in lower limb amputation in patients with diabetic foot based on vascular intervention of peripheral arterial disease in Korea: a population-based nationwide study","volume":"34","author":"Kim J","year":"2019","unstructured":"Kim J, Chun DI, Kim S, et al: Trends in lower limb amputation in patients with diabetic foot based on vascular intervention of peripheral arterial disease in Korea: a population-based nationwide study. J Korean Med Sci 34: e178, 2019."},{"key":"B14","series-title":"JAPMA","article-title":"Effect of direct endovascular revascularization based on the angiosome model on risk of major amputations and life expectancy in type 2 diabetic patients with critical limb ischemia and foot ulceration","volume":"111","author":"Iacopi E","year":"2021","unstructured":"Iacopi E, Coppelli A, Goretti C, et al: Effect of direct endovascular revascularization based on the angiosome model on risk of major amputations and life expectancy in type 2 diabetic patients with critical limb ischemia and foot ulceration. JAPMA 111: Article_3, 2021."},{"key":"B15","series-title":"Eur Heart J","first-page":"763","article-title":"2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS)","volume":"39","author":"Aboyans V","year":"2018","unstructured":"Aboyans V, Ricco JB, Bartelink MEL, et al; ESC Scientific Document Group: 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J 39: 763, 2018."},{"key":"B16","series-title":"Foot Ankle Int","first-page":"731","article-title":"Complications after multiple-site peripheral nerve blocks for foot and ankle surgery compared with popliteal sciatic nerve block alone","volume":"39","author":"Park YU","year":"2018","unstructured":"Park YU, Cho JH, Lee DH, et al: Complications after multiple-site peripheral nerve blocks for foot and ankle surgery compared with popliteal sciatic nerve block alone. Foot Ankle Int 39: 731, 2018."},{"key":"B17","series-title":"Clin Auton Res","first-page":"53","article-title":"The hemodynamic and pain impact of peripheral nerve block versus spinal anesthesia in diabetic patients undergoing diabetic foot surgery","volume":"30","author":"Lai HY","year":"2020","unstructured":"Lai HY, Foo LL, Lim SM, et al: The hemodynamic and pain impact of peripheral nerve block versus spinal anesthesia in diabetic patients undergoing diabetic foot surgery. Clin Auton Res 30: 53, 2020."},{"key":"B18","series-title":"Can J Anaesth","first-page":"1356","article-title":"Practice advisory on the bleeding risks for peripheral nerve and interfascial plane blockade: evidence review and expert consensus","volume":"66","author":"Tsui BCH","year":"2019","unstructured":"Tsui BCH, Kirkham K, Kwofie MK, et al: Practice advisory on the bleeding risks for peripheral nerve and interfascial plane blockade: evidence review and expert consensus. 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Phys Med Rehabil Clin N Am 27: 687, 2016."},{"key":"B21","series-title":"Anesth Analg","first-page":"265","article-title":"A prospective, randomized, controlled trial comparing ultrasound versus nerve stimulator guidance for interscalene block for ambulatory shoulder surgery for postoperative neurological symptoms","volume":"109","author":"Liu SS","year":"2009","unstructured":"Liu SS, Zayas VM, Gordon MA, et al: A prospective, randomized, controlled trial comparing ultrasound versus nerve stimulator guidance for interscalene block for ambulatory shoulder surgery for postoperative neurological symptoms. 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Rev Esp Cardiol (Engl Ed) 71: 553, 2018."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/114\/2\/21-115.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/114\/2\/21-115.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/114\/2\/21-115.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:19:34Z","timestamp":1783505974000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/114\/2\/21115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":25,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.7547\/21-115","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2024,3]]}}}