The study was conducted on 45 pediatric patients subjected to elective cardiac or thoracic procedures. They were divided into three equal groups. Group G, (General group), group (EG) (combined general-epidural group), and group (SG) (combined general-spinal group), 15 patients each. The study aimed to compare pediatric patients receiving general anesthesia to those receiving combined general and regional anesthesia as regard the intra-operative stress response, postoperative acid base balance, time of extubation, pain score, duration of analgesia, duration of hospital stay. The study found that the use of epidural and spinal anesthesia in infants and children attenuate the stress response, with consequent greater circulatory stability, and better postoperative pain control compared with general anesthesia and postoperative intravenous opioid analgesia. This work concluded that: regional anesthesia facilitate tracheal extubation in the operating room, or immediately after surgery, and may reduce complications and the expense associated with mechanical ventilation in the postoperative period.