The article generalizes experience in anesthesiological management of 178 elderly and old-aged patients with fractures of the proximal segment of the femur in endoprosthesis with a Mura-Cito prosthesis, 3-flange nail, Shesterni's fixation device, arched nail, etc. In contrast to endotracheal anesthesia and local anesthesia with neuroleptanalgesia potentiation, prolonged epidural anesthesia in 51 patients produced adequate intra- and postoperative anesthesia without causing respiratory complications and depression and facilitated early activation of the patient. Prolonged epidural anesthesia had advantages over other types of anesthesia in this category of patients.