Saturday you are on call. You are the ONLY anesthesia in the hospital.

General surgeon tells you he has a patient who needs an I&D of a right foot ulcer. He would like to do it now and its 8am. Patient ate a full breakfast at 7 am. This is the only thing keeping the patient in the hospital and they would like to d/c him today

Hx: 58 y/o male Wt: 275 Ht: 5'9"

Renal Failure last dialysis thursday
COPD (mod-severe)

Rx: all you would expect.

Foot ulcer is deep, runs medial of inside of foot up to big toe. Its about 5 CM in length and deep. Pt states he has pain when its even touched.

Attached pic isnt exactly the same but location is similar with extension medial

What do you do?