Introduction: Thoracocotomy is one of the surgical operations associated with sever pain, and in alleviation of post- thoracotomy pain, which is associated with important physiologic, psychologic, ad pathologic consequences. Each method has its own advantages and disadvantages. The post- operative analgesic method used most frequently in each treatment center is considered as method of choice in that center. In this meta- analysis, frequently used post- thoracotomy analgesic methods were compared. to find the best reliable method for pain control with the least side effects and/ or side effects.

Methods: We compared the post- thoracotomy pain in first 24 hours as measured by visual analog scale for patient groups undergoing epidural analgesia plus systemic opioids, epidural analgesia plus intercostals nerve block (INB), epidural plus paravertebral block (PVB), and epidural plus interplural information was assessed from 28 randomized clinical trials that compared these methods two among 1697 post- thoracotomy patients. Random effects model, effect size index, and standardized mean differences were used. Statistical values were assessed using standard errors and results were using 5% lower and upper confidece limits.

Results: Epidural analgesia has had better effects with less side effects in comparisson with systemic administeration method during first 24 hours. ( 95% CI= 0.9812 to 0.3844) Epidural method has had no significant difference with intercostal nerve block during average first 24 houes ( 95% CI= O 2171 to + 5906 ) Epidural analgesia has had better effects in comparisson with interpleural method in first. 24 hours ( 95% CI= - 101166 to – 0.0106). Epidural analgesic is more effective than paravertebral method in the first 24 hour (95% CI= + 01744 to – 0.4572).

Conclusion: In conclusion to our study it seems that. Epidural analgesia is suitable and preferable method for post- op. analgesia at most circumstances.More studies with much more articles will evaluate this results in the future.

  Hakim Research Journal 2008 11(2): 12- 21.