The combination of general anesthesia to spinal and epidural techniques (CSEGA) proved to have a synergistic effect, thus, the use of sub-anesthetic doses can provide satisfactory anesthetic and analgesic results. CSEGA has several known advantages including appropriate postoperative analgesia, shows some benefit in the intraoperative blood loss control causing a decreased need for blood transfusion, rapid regain of the gastrointestinal actions and decreases the incidence of postoperative respiratory complications. Unfortunately, the drawbacks of using neuro-axial anesthesia in combination to general anesthesia will be not thoroughly introduced in many researches, thus, remain unclear.

1. Inclusion criteria:

   • Patients aged from 18 to50 years.
   • ASA I-II.
   • undergoing elective liposuction surgery
   • BMI from 25 to 40 kg/m2

2. Exclusion criteria:

   • Patient refusal
   • ASA III-IV.
   • Patients aged less than 18 or more than 50.
   • Body mass index >40.
   • Any contraindications to neuro-axial block such as coagulopathy or spine deformity
   • Chronic opioid consumption,
   • History of parenteral or oral analgesic intake within the last 48hours.

still working