الفهرس 
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Abstract
Acute pain is an essential warning signal that alerts the human to either the presence or the potential of stimuli that cause tissue damage. Detection and assessment of nociception represents one of the present challenges in anesthetic practice. The noxious stimuli, during general anesthesia, are either due to endotracheal intubation or surgical incision. The brain is the center for pain sensation so the imaging of the brain by EEG could give a great idea about the degree of pain felt by the patient and how to decrease or even abolish this pain. We aimed to compare EEG changes in generally anesthetized patients with regional analgesia to those without regional analgesia and detecting to which extent nerve block abolish noxious stimuli that is reflected on the EEG changes.A comparison has been made between two groups of patients (epidural analgesia group and non-epidural analgesia group), each group consisted of thirty patients scheduled for elective abdominal surgery. In both groups the EEG electrodes were connected to the scalp and general anesthesia (GA) was induced. In epidural group, 15 ml of plain Buivacaine (0.25%) was administered in the epidural space before GA. In non-epidural group, IV morphine (0.1mg/kg) was injected 5 minutes before induction of GA.The pre-noxious stimulus period consisted of the one minute EEG segment 70s to 10s before initial laryngoscopy or before incision. The post-noxious stimulus period was the one-minute segment beginning 40s after successful intubation or after incision. The segments then analyzed for 3 parameters, namely sleep spindle-like (‘10Hz-score’), burst-suppression-like fluctuations in high frequencies (‘high frequency variation index’ (HFVI)), and traditional quantification of non-episodic delta waves.Results were collected, tabulated, statistically analyzed by IBM personal computer and statistical package SPSS version 16 using Student’s t-test, Chi-Squared (χ2), Paired t test, Pearson’s Correlation analysis (r), and P value (Significant P <0.05, Insignificant P > 0.05, Highly significant P < 0.001).Highly significant statistical difference was found between the pre- and post- noxious EEG values within the same group, while comparing between both groups, no statistical significant difference was detected regarding the 3 parameters of comparison. The pre- post-intubation difference showed significant difference between both groups regarding the 10-Hz Score (non-epidural group showed less changes from pre to post-intubation than epidural i.e. better analgesia in non-epidural group due to morphine effect). There was no significant difference between both groups regarding HFVI and Delta Power Pre post-intubation difference. Pre post-incision difference showed significant difference between both groups regarding the 10-Hz Score and HFVI, and high significance regarding the Delta Power (epidural group showed less changes from pre to post-incision than non-epidural i.e. better analgesia in epidural group due to epidural analgesia.