A 5-year-old 16kg male (ex-24 week) with an extensive history of abdominal surgeries is scheduled for another exploratory laparotomy. He has a history of short gut syndrome, osteopenia, and prior multi-level thoracic fractures. He also has a superior mesenteric vein thrombus and left common femoral vein thrombus that is managed on prophylactic enoxaparin BID. Hematology will hold the enoxaparin twelve hours prior to the procedure with the plan to restart postoperatively. His parents are appropriately worried as pain control has been challenging in previous surgeries. The pediatric general surgeon consults you for assistance with post-operative pain management plan after his exploratory laparotomy.


Which of the following is the best regional technique for acute postoperative pain control as an epidural is contra-indicated?