A 3-yr-old female with cryptogenic cirrhosis presented for a liver transplant. After the induction and intubation, we performed a supplemental caudal block with a 22-gauge B-bevel needle in the usual sterile fashion, and 0.6 mg of Duramorph was injected without complications. Initially, the 14.9-kg child received a total of 110 microg of fentanyl in the first 2 h of the 6-h operation and was maintained on air-oxygen-isoflurane. The child was easily tracheally extubated and remained hemodynamically stable. In the pediatric intensive care unit, she was weaned off oxygen, out of bed, and required minimal pain control in the first 18 h.