الفهرس 
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Abstract
This study was conducted on 20 patients submitted for lower limb surgery in Mansoura University Hospital, they were randomlyclassified into two groups 10 patients per each according to the type of anaesthesia. The first group received a combination of ketamine and midazolam by continuous intravenous infusion. The second group received epidural ketamine - bupivacain. Haemodynamic data were recorded non invasively (HR,BPand 02 sat.) and postoperative analgesia was recorded using Visual analouge score (V.A.S). Data were collected and analysed statistcally. It was concluded that both technique could achieve a stable haemodynamic profile, but there was significant pain relief for TIVA group at 16,18,20,24 hour postoperativly com paired to the epidural group of patients. This can be solved for the epidural group by giving postoperative incrimintal doses of ketamine through the introduced epidural catheter.