Clinical Research Directory

Inclusion Criteria: * Age from 18 to 60 years. * Both genders. * American Society of Anesthesiologists (ASA) physical status classification II or III. * Scheduled for thoracotomy. Exclusion Criteria: * Poor cardiac function (ejection fraction less than 50%). * Patients with bad pulmonary function testing (PFTs). Absolute contraindication to thoracic epidural anesthesia includes patient refusal, allergy to local anesthetics, coagulopathy, active neurologic disorders, skin infection at the insertion site, uncooperative patients, uncontrolled cough, and unfavorable anatomy for thoracic epidural. * Thoracic spine disorders require chest wall resection or emergency thoracic surgery. * Had a previous thoracotomy (scarring due to prior surgery can limit the effectiveness of paravertebral block, and these patients may have existing chronic pain).