In this trial, the investigators intend to examine whether the concentration of local anesthetics during epidural analgesia could be modulating factor for change of hemodynamics in patients undergoing major upper abdominal surgery.

One hundred and twenty patients scheduled for major abdominal surgery under TEA combined general anesthesia were randomized in a double-blinded method to receive one of three different concentration study solutions in 8 ml of volume after the induction of anesthesia: 0.75% ropivacaine (60 mg), 0.375% ropivacaine (30 mg), or 0.2% ropivacane (16 mg).

In each group, the patients were divided into two subgroups at the age of 60 to perform age based analysis. The acquired hemodynamic data after administration of epidural loading dose were compared and analyzed between young and elderly groups in each group.

Inclusion Criteria: all of the followings needed.

• ASA I or II patients
• 18 to 65 years old
• undergoing major upper abdominal surgery
• planned combined thoracic epidural analgesia and general anesthesia

Exclusion Criteria:

• any contraindication to epidural analgesia
• allergy to local anesthetics of the amide type
• communication difficulties that would prevent reliable assessment
• known significant cardiac or respiratory disease
• pregnant
• patients who were not in cardiac sinus rhythm