Levy N, Santer P, Zucco L, et al. - Researchers conducted this retrospective study to assess whether intravenous opioid rescue analgesia in the post anesthesia care unit (PACU-OpResc) has utility as a single marker of thoracic epidural analgesia (TEA) failure. They also assessed the resource implications as well as quality improvement applications of this measure. They analyzed all TEA placements during a three-year span at a single academic medical center in Boston, Massachusetts. They found PACU-OpResc was needed in 211 (22.1%) patients who had preoperative TEA, and was related to a longer post anesthesia care unit length of stay as well as delayed discharge attributable to inadequate pain control. Findings show that PACU-OpResc can be employed as a quality assurance measure or proxy for TEA efficacy, to trace performance as well as monitor innovation attempts focused at improving analgesia, such as experts’ intervention to facilitate sensory level checks and decreased PACU-OpResc.