We conducted a retrospective study to evaluate the relationship between post-thoracotomy pain syndrome (PTPS) and early postoperative analgesia with multimodal analgesia administered via a combination of patient-controlled epidural analgesia (PCEA) and nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who had undergone video-assisted lobectomy for lung cancer. A total of 73 adult patients were divided into 2 groups: group A included 12 patients (16.4%) with PTPS, and group B included 61 patients without PTPS. All patients received postoperative multimodal analgesia via a combination of NSAIDs and PCEA with a mixture of 2 microg x ml(-1) fentanyl and 1.5 mg x ml(-1) ropivacaine. For statistical analyses, unpaired t-test, Mann-Whitney test and chi square test were used and considered P significant if lower than 0.05. Pain intensity was measured on a 100-mm non-graduated visual analogue scale (VAS), and it was significantly greater in group A (8 mm) than that in group B (2 mm). There was no significant difference between groups in pain intensity during movement, with a VAS score of 33 mm in group A and 35 mm in group B. The number of PCEA bolus injections given to patients was significantly higher in group A (3 times) than in group B (2 times). The duration of PCEA was also significantly longer in group A (4 days) than in group B (3 days). There was no significant difference in the rate of NSAIDs usage between the 2 groups This study demonstrated a significant difference in early postoperative pain intensity between patients with PTPS and those without. We conclude that there is a possibility of intervention in the early postoperative period in patients who underwent thoracic surgery.