The choice of anesthetic technique based on its advantages and disadvantages in elderly patients will inevitably be influenced by the patient's comorbidities, such as cardiovascular disease, diabetes mellitus, stroke, renal insufficiency, and pulmonary disease. The patient's underlying cardiac conditions, although apparently stable at present, may become manifest during perioperative stresses. Caudal epidural block should be taken into consideration as a safe and effective anesthetic technique for the elderly patients who have limited cardiac reserve and comorbidities. Six patients with low ejection fraction and poor functional status due to ischemic cardiac disease scheduled for surgery under caudal epidural block are presented.

The choice of anesthetic technique based on its advantages and disadvantages in elderly patients will inevitably be influenced by the patient's comorbidities, such as cardiovascular disease, diabetes mellitus, stroke, renal insufficiency, and pulmonary disease. The patient's underlying cardiac conditions, although apparently stable at present, may become manifest during perioperative stresses. Caudal epidural block should be taken into consideration as a safe and effective anesthetic technique for the elderly patients who have limited cardiac reserve and comorbidities. Six patients with low ejection fraction and poor functional status due to ischemic cardiac disease scheduled for surgery under caudal epidural block are presented.