Comparison of Fast track with routine regimen in reducting postoperative thoracotomy pain and respiratory complications

INTERVENTION: Bupivacaine 0.25% + Fentanil (1mg per hour) for 3 days after thoracotomy via epidural catheter Intervention 1: Bupivacaine 0.25% + Fentanil (1mg per hour) for 3 days after thoracotomy via epidural catheter. Intervention 2: Morphine (1mg per hour intravenous + Intercostal block with marcaine 0.25% for 3 days. Morphine (1mg per hour intravenous + Intercostal block with marcaine 0.25% for 3 days Treatment ‐ Drugs CONDITION: Benign and Malignant disease of the lung, reduction of operative complications with regional anesthesia. J70, J94, PRIMARY OUTCOME: ICU needed. Timepoint: Daily until one week after surgery. Method of measurement: Respiratory postoperative pain and clinical symptom. Mechanical ventilation needed. Timepoint: Daily until one week after surgery. Method of measurement: Respiratory postoperative pain and clinical symptom. Post‐thoracotomy pain. Timepoint: Daily until one week after surgery. Method of measurement: Respiratory postoperative pain and clinical symptom and signs (Pain seeing measurement). Respiratory complications. Timepoint: Daily until one week after surgery. Method of measurement: Respiratory postoperative pain and clinical symptom. SECONDARY OUTCOME: Mortality. Timepoint: Daily until one week. Method of measurement: Death rate. INCLUSION CRITERIA: INCLUSION CRITERIA: Both genders of patients with pulmonary disease which treated with elective thoracotomy, absence of blood coagulopathy, class I, II, or III American society of Anesthesiology, no underlying disease (pneumonia, Bronchitis, Asthma) Exclusion criteria: class IV, V ASA, FE less than 40%, patients with Aortic stenosis, intraoperative bleeding more than 25% that needed blood transfusion, Time of Surgery more than three hours