ABSTRACT
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. 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. 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 hours [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]. 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