IRCT201112318566N1 IRCT 2012-01-31 Hamedan Univercity of Medical Sciences- vice chancellor for research Epidural analgesia and PCA in pain relief after surgery Analgesic effect and complications of thoracic epidural analgesia compared with IV- PCA(patient controlled analgesia ) in patients under thoracic and upper abdominal surgeries 2012-01-05 anticipated 144 Complete https://irct.ir/trial/9060 interventional Randomization: N/A, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment. 2 Acute postoperative pain. Intervention 1: Intervention in epidural group patients: after the replacement of the intravenous catheter and infusion of 500CC normal saline, 30 minutes before surgery, thoracic epidural catheter 20G through 18G needle in the intervertebral space T8-T9 or T7-T8 with Loss of resistance is placed in a sitting position. After fixing the catheter patients will undergo non-invasive monitors. A Test dose of bupivacaine% 0.25: 5ml with epinephrine 1 / 200000: 1ml is injected through the catheter. For surgical procedure all patients receive midazolam, fentanyl, thiopental and muscle relaxant for induction of anesthesia. In postoperative period a pharmaceutical composition containing 2mg of morphine and 6-8ml of 0.125% bupivacaine is injected through epidural catheter every 8 hours. Control of blood pressure and heart rate will be performed before induction of anesthesia and after transmit ion to the surgical ward, then will be recorded every 24 hours to 72 hours after the operation. Intervention 2: Intervention in PCA group: patients will be educated for proper use of PCA system in preoperative and postoperative periods. After surgery, morphine (1mg/ml) to the 2.5 ml (within 10-minute intervals by the patient) will be injected through a PCA pump. After surgery, patients with certain commands for analgesia are transmitted to the ward. In all patients every 24 hours to 72 hours after surgery, amount of analgesia and the rate of complications, including complications due to surgery will be recorded. While patients are being discharged, they are questioned to determine the level of satisfaction.