It is known that postoperative pain after thoracotomy or lobectomy is very severe, therefore, intraoperative or postoperative pain management using continuous thoracic epidural catheterization is suggested good option to prevent this complication.

The spread of local anesthetics is influenced by various factors including volume, location of needle insertion, speed of injection, patient position, age, weight and height. However, there are few studies about the effect of different patient position during thoracic epidural catheterization.

This study was designed to evaluate the effect of different patient position affecting thoracic epidurography.

It is known that postoperative pain after thoracotomy or lobectomy is very severe, therefore, intraoperative or postoperative pain management using continuous thoracic epidural catheterization is suggested good option to prevent this complication.

The spread of local anesthetics is influenced by various factors including volume, location of needle insertion, speed of injection, patient position, age, weight and height. However, there are few studies about the effect of different patient position during thoracic epidural catheterization.

Studies of lumbar epidural blockade have shown that lateral position can produce 0-3 segment more to the dependent position compared to the supine position. When the same amount of local anesthetic was injected in supine of sitting position, the most cephalad level of spread was indifferent.

Recent studies showed that neck flexion demonstrated significant cephalad spread of contrast dye in high thoracic epidural blockade.

The purpose of this study was to compare and evaluate the contrast dye spread between different patient position

Inclusion Criteria:

• lung cancer
• liver cancer
• stomach cancer
• pancreas cancer

Exclusion Criteria:

• coagulopathy
• infection
• previous spine fusion at thoracic level