Society for Pediatric Pain Medicine
Better Care for Children in Pain

November 2023 POLL OF  THE MONTH

November 2023 QUESTION OF THE MONTH

A 3-month-old infant undergoes a Kasai procedure for biliary atresia. An epidural catheter was threaded from the caudal space to the thoracic level, and the position was confirmed by an epidurogram. On post-op day #1 the bedside nurse states that they do not think the epidural is working because the baby cries intermittently and sometimes appears uncomfortable. FLACC scores have been between 0-6. The baby has an NG tube in place, a right radial arterial line, and 2 peripheral IVs in the upper extremities.

Which of the following techniques is best for determining whether the epidural is functional or not?

A. Confirm the position of the epidural with Ultrasound
B. Use the Wong-Baker Faces Pain Scale in place of the FLACC
C. Check dermatome levels by gently palpating along the chest and abdomen
D. Stop the epidural and look for increased pain behavior

Answer the Question