Thoracic but not lumbal epidural anesthesiaprovides relevant clinically advantages compared withgeneral anesthesia improving patients morbidity andmortality after major surgical procedures．Theseadvantages are excellent perioperative neuroaxialanalgesia and effective attenuation of theperioperativestress response by a reversible blockade ofsympathetic afferents and efferents．In particular，theattenuation of sympathetic tone preventsperioperative myocardial ischemia and improves globalandregional left ventrieular function，pulmonaryfunction,and gastrointestinal perfusion．Thus，thoracicepidural anesthesia is more than only an anestheticregimen but it have therapeutic options especially inhigh risk patients who underwent major cardiac，thoracic or abdominal surgical procedures．