Question of the Month – May 2018 17 year old male with Ewing sarcoma of Left 7th rib with bilateral pulmonary metastases scheduled for chest wall resection (en bloc with 6th, 7th, and 8th ribs together with diaphragm and left lower pulmonary lobe), left upper lobe and left lower lobe pulmonary wedge resections. PMH: pneumonia 2 months ago -resolved. Otherwise unremarkable.Preop labs - Hemoglobin: 10.3 (L)Hematocrit: 30.9 (L)Platelet Count: 193Fibrinogen: 338INR: 1.0Part Thromboplastin: 59.8 (H)Prothrombin Time: 13.4The anesthesia team in the room has tried placing an awake thoracic epiduralwithout success. You are called to suggest options for pain management.What postoperative pain management options would you then choose?1. PCA only2. Thoracic epidural catheter under GA3. Paravertebral catheter with PCA supplement4. Erector spinae plane block with PCA supplementTime is Up!