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Epidural anesthesia during lower extremity free tissue transfer.

A continuous epidural bupivacaine infusion was used for anesthesia in 20 patients who underwent lower extremity free tissue transfer. In 60 percent of the patients, general anesthesia supplementation with nitrous oxide was used for comfort during prolonged lying on the operating table. In all cases, this technique provided adequate surgical anesthesia with no obvious untoward effects. The same infusion was used in seven patients who underwent further operative procedures a few days later. This technique is simple, requires minimal or no general anesthesia supplementation, provides a perioperative and postoperative sympathectomy effect, and provides postoperative analgesia or anesthesia for as long as it is continued.