The Hemodynamic Effect Between Two Types of Anesthesia in Esophageal Surgery

Comparison of the Hemodynamic Effect Between the Paravertebral Block and Thoracic Epidural in Esophageal Surgery With Thoracotomy .

Continuous Paravertebral block (PVB) was reported to provide less episodes of hypotension than continuous thoracic epidural block (TEB). The maintenance of optimal tissue perfusion is essential for esophageal anastomosis in patients undergoing oesophagectomy. the aim of this study is to compare Hemodynamic effect of continous PVB compared to TEB , in patient undergoing oesophagectomy with laparoscopy and thoracotomy.

Inclusion Criteria:

• ASA score 1 to 3
• oesophagectomy : abdominal time with laparoscopy ans thoracic time with thoracotomy

Exclusion Criteria:

• pregnancy
• Uncooperative patient
• patient refusal
• Coagulopathy
• allergy to local anesthetic
• Psychological Disorders
• Failure to install the epidural or paravertebral catheter. The patient will therefore be excluded secondarily but will be able to benefit from an alternative technique for the management of his pain.
• Sepsis
• Skin infection at the puncture site
• Allergy to local anesthetics
• Esophagectomy with cervical surgical time
• Patient with chronic pain EVA> 4 before surgery.