What would you do at the end of the case?

Here is what we did: 

The patient was transported to the ICU at the end of the case, hemodynamically stable, awake, and with pain well-controlled via the PCEA infusion of bupivacaine 0.125% with fentanyl 5 mcg/ml. and resumed on home meds (including Vicodin(R) and oxycodone). The patient received a routine, but reduced dose of warfarin 0.5 mg once for deep vein thrombosis prophylaxis. The patient still complained of pain, so IV PCA hydromorphone was added. The patient was seen in hospital by the acute pain service attending for epidural catheter management, when she began to complain of back pain. The onset of progressively severe low back pain occurred ten hours after surgery with no motor or sensory deficits. Pain radiated from the back towards the umbilicus. The pain was so severe that the patient insisted on the removal of the epidural catheter even before performing MRI. Physical examination revealed nonspecific tenderness on multiple levels of the thoracolumbar region. The site of the epidural catheter was clean and dry with no signs of erythema or induration. Induration is one of the most important signs of catheter infection.