【Abstract】Objective To investigate insulin resistance to thoracic surgery with different anesthesia and analgesia and effects on correlative factors. Methods 54 ASAⅠ-Ⅱpatients undergoing thoracic surgery were randomized to receive either general anesthesia and PCIA (GA, n=29)or general anesthesia combined with epidural anesthesia and PCEA (GEA, n=25). Peripheral venous blood samples were taken before induction of anesthesia, at the end of surgery and on the morning of postoperative day 1, for determination of plasma hypersensitivity C-reactive protein（HCRP）, blood glucose (FPG), interleukin-6(IL-6), resistin(RESIS) and insulin(FINS). Postoperative pain was assessed by VAS at the following time points：2h, 6h, 10h after operation and on the morning of postoperative day 1. While insulin resistance was assessed by Hemeostasis Model Assessment(HOMA). The correlation between HOMA and hypersensitivity C-reactive protein, interleukin-6 and resistin was analysised at the end of surgery and on the morning of postoperative day 1. Results There were no significant differences in age, sex ratio, BMI, and operative duration between both groups. To compare with before induction of anesthesia and the end of surgery, HCRP and IL-6 significantly increased on the morning of postoperative day 1 in both groups respectively (P<0.01). To compare with the end of surgery, FINS significantly increased on the morning of postoperative day 1 in both groups respectively (P<0.01). GA: from (20±10) to (30±12)；GEA: from (18±7) to (26±10). To compare with before induction of anesthesia, FPG significantly increased at the end of surgery and on the morning of postoperative day 1 in both groups respectively (P<0.01). In the GEA, FPG significantly decreased at the end of surgery (6.4±1.4)and on the morning of postoperative day 1 (6.4±1.2)respectively (P<0.05). To compared with before induction of anesthesia and the end of surgery, HOMA significantly increased on the morning of postoperative day 1 in both groups respectively (P<0.01). In GEA group(2.3±1.6), HOMA significantly decreased (2.0±1.1)on the morning of postoperative day 1(P<0.05). In both groups, there was no significant change on RESIS and VAS. There were significant positive correlation between HOMA and hypersensitivity C-reactive protein and resistin at the end of surgery(r=0.61). While there were significiant positive correlation between HOMA and interleukin-6 and resistin on the morning of postoperative day 1(r=0.51). Conclusions Hemeostasis Model Assessment showed that (1) Insulin resistance decreased on the morning of postoperative day 1 with general anesthesia combined with epidural anesthesia and PCEA . (2) There were significant positive correlation between HOMA and hypersensitivity C-reactive protein and resistin at the end of surgery. While there were significiant positive correlation between HOMA and interleukin-6 and resistin on the morning of postoperative day 1.