Abstract: Objective:To compared the effects of hypobaric spinal anesthesia and general anesthesia in elderly patients treated with artificial femoral head replacement.Methods:Thirty-six elderly patients with ASAⅠ to Ⅲ treated with artificial femoral head replacement,without uncontrolled heart failure,pneumonia and atelectasis,were randomly divided into the bupivacaine hypobaric spinal anesthesia group(group A) and general anesthesia group(group B).The amount of bleeding,recovery time of limb function,postoperative pulmonary complications,hospital stay and total hospitalization expense between two groups were compared.Results:The differences of the amount of bleeding and postoperative pulmonary complications between two groups were not significant(P>0.05).The motor function recovery time of lower limb in group A was longer than that in group B(PPConclusions:Hypobaric spinal anesthesia with bupivacaine is more suitable for the elderly patients treated with artificial femoral head replacement,which is a good anesthesia way.