الفهرس 
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Abstract
Perioperative pam is a potent trigger for the stress response, activates the autonomic nervous system, and is thought to be an indirect cause of adverse effects on various organ system. Thoracotomy is an operation of considerable risk, causing severe postoperative pain and marked impairment of pulmonary function. Tramadol is a dual-action analgesic drug with predominantly ~opioid agonist and noradrenaline and serotonin release, and reuptake blocker action and an active metabolite. This study was designed to evaluate the efficacy of thoracic epidural tramadol analgesia in comparison with thoracic epidural morphine in thoracotomy. Twenty patients, aged 20-50, undergoing lobectomy, were divided into two groups : A- Morphine group: received 50 ~g/kg in 10 ml normal saline in thoracic epidural space. B- Tramadol group : received 100 mg tramadol in 10 ml normal saline in thoracic epidural space. Postoperative pain (using VRS), heart rate, blood pressure, respiratory rate, PC02, P02, Sa.02 and complications were assessed every two hours for 12 hours and then every 6 hours for another 12 hours. We found that thoracic epidural tramadol, like morphine, can provide adequate postoperative analgesia in patients undergoing lobectomy.