الفهرس 
Anatomical considerationsOnly 14 pages are availabe for public view
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Abstract
Epidural anesthesia is the most versatile and extensively utilized of the currently available regional techniques. It is used not only for surgery but also for management of both chronic and acute pain.
Thoracic epidural analgesia offers the post operative benefit of enhanced pain relief, decreased use of systemic analgesics, improved pulmonary function, early extubation and ampulation as well as early return of gastrointestinal function.
The aim of this work is to compare the analgesic effect of thoracic epidural ropivacaine, fentanyle and their combination for postoperative pain relief in patients undergoing upper abdominal and thoracic surgeries. Our study includes sixty adult patients of both sexes , aged from 18 to 60 years were included in the study They were scheduled for upper abdominal and chest surgeries such as whipple operation , lobectomy , pleural decortication and cancer lower 1/3 oseophaus . All patients have Combined thoracic epidural and general anesthesia . they were divided Into three equal groups ( 20 patients in each group ) :
Group I (Ropivacaine group ) :- ropivacaine 0. 2 % 5
M as initial dose and subsequent top up doses .
Group II (Fentanyl group ) :- received thoracic
epidural fentanyl 2 mcg / kg 5ml and fentanyl 1 mcg /
epidurally as subsequent top up doses.
Group III (Ropivacaine – Fentanyl group) :- received ropivacaine 0 15 % 5ml plus fentanyl 25mcg as Intraoperative dose and subsequent top up doses postoperative.