Ｏｂｊｅｃｔｉｖｅ　To clarify the hemodynamic effects of phenylephrine added to local anesthetic during epidural analgesia in elderly patients.　Methods　Thirty elderly(65 y) patients who underwent elective total hip arthroplasty or semi?蛳hip arthroplasty under epidural anesthesia were randomly divided into the control and observation group(n=15). Patients in the control group received lidocaine (2% lidocaine 17 ml + normal saline 3 ml), whereas those in the observation group received lidocaine plus phenylephrine (2% lidocaine 17 ml + 0.1% phenylephrine 3 ml) for epidural anesthesia. The hemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, cardiac output index(CI), and stroke volume index (SVI) were recorded at 1 min(T0) before and 5 min(T1), 15 min(T2), 30 min(T3) and 60 min(T4) after epidural injection and at the end of surgery(T5). The doses of ephedrine were recorded.　Results　The mean dose of ephedrine used during anesthesia was significantly lower in the observation group than in the control group ［(1.5±3.2) mg vs (6.4±8.6)　mg］(P＜0.05). When compared with T0, the SVI was significantly higher at T3, T4 and T5 in the observation group ［(35±8), (36±9), (36±9) ml/m2 vs (31±8) ml/m2］(P＜0.05).　Conclusions　Phenylephrine, when mixed with local anesthetics, can decrease the requirement of ephedrine and increase the SVI during epidural anesthesia in elderly patients.