In this issue of the Journal, Tobias et aL ~ report their experience with thoracic epidural anaesthesia (TEA) in children. The strength of this report rests in its description of the management of TEA in children and the use of a database as a mechanism for assisting quality improvement and assessment of performance. The authors advocate careful clinical management: placing epidural catheters as close as possible to the epidural site of action, checking catheter placement radiologically, using appropriate concentrations and doses of analgesic, and careful monitoring of patients for expected complications. Their descriptive paper manifests a changing style of practice for paediatric anaesthetists and physicians involved in the management of pain. Regional anaesthesia in children is now commonly used for surgery, and very specific interventions are used for the management of postoperative pain. The authors have summarized well the current knowledge about the access to the thoracic epidural space, and they have demonstrated the feasibility of direct placement of catheters at the thoracic level in children. Tobias et al. maintained a database of their patient population so that they would be able to review, on the basis of clinical reporting, their success with the management of pain. Establishing a database for patients who require services of a pain management team is proving to be a very useful tool: If there is no prospectivelyestablished database, the identification of any group of previously managed patients becomes burdensome. Databases such as the one used in this study may be useful for designing descriptive studies, for identification of prognostic factors, for providing aids in diagnosis, and for determining the feasibility and design of contemplated randomized trials. This report raises two important questions: is it reasonable to draw conclusions about safety of TEA from