• Jingwei Dai, Mengya Yang, and Shanliang Li.
• Department of Anesthesiology, Hainan Wanning People's Hospital, Wanning Hainan, China.
• Medicine (Baltimore). 2023 Jul 21; 102 (29): e34431e34431.

RationaleColorectal cancer is the third most common cancer and the second leading cause of cancer-related deaths worldwide. Opioid-free anesthesia (OFA) is an opioid-sparing technique that focuses on multimodal or balanced analgesia, relying on non-opioid adjuncts and regional anesthesia. Enhanced recovery after surgery (ERAS) protocols, often under the auspices of a perioperative pain service, can help guide and promote opioid reduced and OFA, without negatively impacting perioperative pain management or recovery. Ultrasound-guided regional nerve block is currently a good option for OFA due to anesthesiologists' mastery of ultrasound techniques. The safety of the OFA strategy for quadratus lumborum block (QLB) + transversus abdominis plane block (TAP) in the super-elderly patients has not been reported and remains unclear. We report a case of OFA anesthesia in a super-elderly patient with colon cancer.Patient ConcernsA 102-year-old female was admitted to the hospital due to "abdominal pain for a week" and received conservative treatment for more than 20 days, with poor results.DiagnosesThe patient was diagnosed with colorectal cancer associated with bronchiectasis and infection, multiple nodules in the right lower lung, and sinus arrhythmia.InterventionsAs the patient was a super-elderly patient with multiple diseases, we used an OFA strategy with general anesthesia combined with QLB and TAP.OutcomesThe patient awakened quickly and completely after surgery, and extubation was successful 2 min after surgery without anesthesia complications, which is in line with the concept of ERAS.LessonsThe OFA strategies of ultrasound guidance quadratus lumborum block (Ul-QLB) and ultrasound guidance transversus abdominis plane block (Ul-TAP) may be safe and effective for ERAS in super-elderly patients with colorectal cancer surgery.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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