Thoracic operations are known to be painful procedures. Patients report moderate-to-severe pain. The aim of the literature reveiw was to study if there is a difference in pain relief with epidural analgesi verus intravenous analgesia in patients after thoracic surgery and if epidural analgesi gives less adverse effects like sedation, effects on lung function, nausea and vomiting. The method was a systmatic literature examination reviewing pertinent research in the area. Nine randomized controled trials were finally included. The results showed that epidural analgesia provided better pain relief than intravenous analgesia and higher pulmonary function after thoracic surgery. There were no difference regarding side effects like postoperative nausea and vomiting or regarding the incidence of sedation. This study has shown that the use of epidural analgesia in six of the studies resulted in better analgesia and better pulmonary function versus intravenous analgesia. Individually pain relief and preventing postoperative nausea/vomiting and sedation need more research.