What Type of Anesthesia for Foot Surgery?

• ‍Loco-regional anesthesia puts a specific part of the body to sleep in order to perform an operation. The goal is to temporarily numb the foot and/or ankle so that you feel no pain during the operation. Nerve impulses are blocked between the operated leg and the brain, therefore the leg is paralyzed and insensitive to pain.‍
• Local anesthesia can be considered for almost all foot and ankle operations. However, some operations still require general anesthesia. In combination with this general anesthesia, a lighter local anesthesia (locoregional analgesia) can be used to reduce post-operative pain and speed up your recovery. 
  

Relative contraindications:

• Blood clotting problems;
• Active infection.

Day of Surgery: What to Expect?

What to Wear?

On the day of the operation, you should wear comfortable clothes. You will leave with a large bandage and/or splint on the operated limb. Your clothes must fit around your bandage and/or splint. You can wear shorts or sweatpants, for example.

Course of the Procedure

1. Just before the operation, the team will ask you to put on a hospital gown;
2. Once you have put on your gown, you will meet with a member of the nursing team who will review your medical file;
3. He or She will also put an IV in one of your arms. This device allows you to receive the necessary medication (painkiller, sedative, antibiotic...);
4. Once the infusion is in place, you will meet the operating room team: operating room nurse, nurse anesthetist, anesthesiologist and surgeon;
5. The anesthesiologist will perform the anesthesia according to the modalities agreed upon with you during the anesthesia consultation: local anesthesia or general anesthesia through the infusion.

How to Prepare ?

A consultation with an anesthesiologist will be arranged before the procedure. Your anesthesiologist may ask for some of the following information:

Potential Medical Examinations Before the Operation

Your medical condition and planned surgery may require you to have tests before surgery. These tests may include:

• Blood tests ;
• X-rays ;
• An electrocardiogram, or a more thorough examination by a cardiologist.

Stopping Certain Medications

Some medications can be dangerous when taken just before surgery. Your anesthesiologist will tell you which medications to stop and when to stop them.

Among the medications that may need to be discontinued:

• Non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen;
• Anticoagulants such as Eliquis, Xarelto, AVK...;
• Oral antidiabetics;
• Contraceptive pill.

Anticoagulants prevent blood from clotting and increase bleeding during surgery. Stopping or continuing them must be evaluated and decided by your doctors (anesthesiologist and surgeon). 

Some birth control pills increase the risk of blood clots. It is therefore sometimes recommended to suspend them for a few weeks after the operation. Discuss this with your anesthesiologist or surgeon.

Some diabetic medications may need to be stopped or the dosage changed. Discuss this with your anesthesiologist. 

Quitting Smoking

Smoking increases the risk of complications during and after surgery. It increases the risk of infection, poor healing and anesthetic complications. 

For the best results during orthopedic foot or ankle surgery, you should quit smoking before surgery. There are several options for quitting smoking, so you may want to talk to your doctor. 

Potential Risks and Complications

• Hematoma;
• Infection;
• Skin healing disorder;
• Algodystrophy (joint stiffness).

After the Procedure

Your surgery will be scheduled either as an outpatient or inpatient procedure. If you are an outpatient, you will go home the same day after eating and drinking in the outpatient department.

The type of foot surgery performed will determine the length and type of post-operative care needed to ensure your recovery is uneventful. Basic postoperative care is designed to enhance and ensure a safe recovery from your foot or ankle surgery. It may include:

• Rest with ice, compression and elevation of the leg;
• Bandages;
• Splint;
• Cast;
• Crutches.

Your surgeon will inform you when you can begin walking again with support on your operated foot.