PERIOPERATIVE STRATEGY FOR MAJOR AMPUTATIONS IN PATIENTS WITH DIABETES, OBESITY AND HEART FAILURE: THE ROLE OF MULTIMODAL ANESTHESIA

of the Ministry of Health of Ukraine "Optimization of anesthetic support for operations with diabetic foot syndrome in obese patients" (state registration number 0120U10217).Introduction.Diabetic foot syndrome (DFS) is one of the most severe complications of diabetes mellitus, often requiring surgical intervention up to high limb amputation.These interventions are accompanied by significant physiological loads, especially in patients with comorbid conditions such as obesity and systolic myocardial dysfunction.Anesthetic management of such patients poses a significant challenge due to the expected high risk of cardiovascular complications, ventilation disorders, hemodynamic instability, increased sensitivity to hypovolemia and a tendency to a pronounced stress response and is