[Acute ischemia of lower limb and long-term treatment with epidural bupivacaine].

We report the treatment of an ischemic lower limb (arterial obstruction shown by angiography at popliteal level, proximal to common tibioperoneal artery) with 0.125% and 0.20% epidural bupivacaine, which was continuously administered by pump during 30 days. Simultaneously, 8 mg morphine chloride was administered every 24 hours by epidural route, anticoagulation with heparin was started, and transcutaneous electrical stimulation was used. The favorable outcome, with sufficient peripheral revascularization, permitted to preserve the limb. During therapy no sign of cardiac toxicity attributable to bupivacaine was detected.