Ultrasound-guided ankle block in diabetic foot surgery: Association between glycemic control and block onset
Journal of Foot and Ankle Surgery, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1053/j.jfas.2026.07.014
- Dergi Adı: Journal of Foot and Ankle Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Anahtar Kelimeler: 3, Ankle block, Glycated hemoglobin, Glycemic control, Peripheral nerve block, Regional anesthesia, Toe amputation, Wound debridement
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Patients undergoing distal diabetic foot surgery commonly have diabetic peripheral neuropathy and substantial systemic comorbidity. Purpose: This study evaluated the association between preoperative glycated hemoglobin (HbA1c) level and ultrasound-guided ankle block onset. Study design: Prospective observational study. Methods: Adults with diabetic peripheral neuropathy undergoing wound debridement or toe amputation were grouped according to HbA1c level (<8.0% or ≥8.0%). The primary outcome was sensory block onset time. Postoperative pain, opioid consumption, and patient satisfaction were also evaluated. Results: Forty-two patients were analyzed. Sensory block onset was shorter in the HbA1c ≥8.0% group than in the HbA1c <8.0% group (4.9 ± 1.1 versus 7.4 ± 2.8 minutes; mean difference, −2.43 minutes; 95% confidence interval, −3.67 to −1.19; p < 0.001). Among patients who developed a measurable motor block, motor onset was also shorter (13.0 ± 3.4 versus 16.9 ± 3.5 minutes; mean difference, −3.89 minutes; 95% confidence interval, −6.36 to −1.43; p = 0.003). Postoperative pain, opioid consumption, and satisfaction were comparable between groups. Higher HbA1c remained associated with shorter sensory onset after covariate adjustment. Conclusions: Poor glycemic control was associated with modestly faster ultrasound-guided ankle block onset in patients with diabetic peripheral neuropathy. The clinical importance of this finding and the potential effect of glycemic control on block duration require further investigation.