BACKGROUND:General anesthesia or continuous epidural anesthesia can be commonly selected for lower limb joint surgery in the elderly. The effect of epidural anesthesia is precise, and can be easily controled. The effect of muscle relaxation is good. However, the time of anesthesia induction is relatively long, and it is not ideal in the control of pain in the visceral peritoneum reflection region. Moreover, circulatory system interference can be greatly affected by lumbar anesthesia. OBJECTIVE:To evaluate the effects of combined spinal-epidural anesthesia with ropicavaine in elderly patients undergoing lower limb arthroplasty. METHODS: Ninety patients undergoing lower limb arthroplasty admitted to Heze Municipal Hospital from September 2013 to November 2014 were chosen and were equaly and randomly assigned to two groups, including 52 cases of knee replacement and 38 cases of hip replacement. Patients in the control group received continuous epidural anesthesia. Patients in the observation group received combined spinal-epidural anesthesia with ropicavaine. Vital signs, onset time of anesthesia, drug consumption, analgesic effect and postoperative side effects were observed and compared in both groups. RESULTS AND CONCLUSION:Heart rate, pulse, and arterial oxygen saturation were significantly lower in the control group than in the observation group. Vital signs in the observation group were more stable, and the significant difference was detected between the two groups (P < 0.05). Onset time of anesthesia and drug consumption were significantly better in the observation group than in the control group, showing very significant differences between the two groups (P < 0.01). The excelent and good rate of analgesic effects was lower in the control group (67%) than in the observation group (89%), which showed significant differences between the two groups (P < 0.05). In the control group, vomiting appeared in 10 cases and dyspnea appeared in 4 cases, with an incidence of side effect of 31%. In the observation group, vomiting appeared in 3 cases and dyspnea in 2 cases, with the incidence of side effects of 11%. The incidence of side effect was significantly higher in the control group than in the observation group (P< 0.05). These data indicate that combined spinal-epidural anesthesia with ropicavaine showed good analgesic effect in elderly patients receiving lower limb arthroplasty. The onset time of anesthesia was short. Drug consumption was low. The incidence of side effects was low.