Cardiovascular and respiratory diseases have been much better: coronary arteries disease reached to 99.24%, hypertension reached to 99.2% and COPD reached to 98.75%. Conclusion: The combined spinal - epidural anesthesia technique with low dose isotonic bupivacaine and sufentanil is adequate to intraoperation and postoperation, effects on the cardiovascular and respiratory system in postoperative episode and decreases rate of complications in Hip Replacement for elderly patients