Abstract
We report a high-risk cachexia patient receiving special regional anesthesia in a colostomy operation. Because of multiple underlying diseases and severe malnutrition status, we combined epidural anesthesia (EA) with transversus abdominis plane (TAP) block. Low concentration EA (Lidocaine 1% as test dose and rescue dose; Bupivacaine 0.2% as loading and maintenance dose) aimed for visceral pain; subcostal TAP block (Bupivacaine 0.25%) focused on the skin incision. The colostomy was done completely without any complication. Our case showed that low concentration EA combined with TAP block provided stable and sufficient anesthesia and could be a sole anesthesia technique in a colostomy.
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