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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionBackground and Aims Continuous spinal anesthesia (CSA) involves inserting a catheter into the subarachnoid space. his main advantage is the titration of the induction dose, which allows for control over the extent of blockade and its onset speed, thereby minimizing side effects, particularly hemodynamic ones. It is primarily indicated in elderly patients. Despite its advantages, CSA remains underused.Methods We report a series of 5 cases demonstrating the value of CSA for lower limb trauma surgery in elderly patients.Results Case 1: 80-year-old female patient , with a history of heart disease, admitted for a left femoral shaft fracture. Chest X-ray showed cardiomegaly. ECG: ACFA. echocardiography: LV dysfunction, EF: 40%. operated under CSA: - 1st injection of 05 mg of bupivacaine + 10 µg of fentanyl; 2nd injection: after one hour: 2.5 mg of bupivacaine After closure, injection of 100 µg of morphine and removal of the intrathecal catheter on the table; - The procedure lasted 1 hour 30 minutes during which the heart rate was unstable ; but no hypotension. Case 2: Patient BF, 86 years old, was admitted for a complex subtrochanteric diaphyseal fracture of her right femur. She has a history of: HBP + diabetes + COPD -1st injection: 2.5 mg bupivacaine + 5 ug fentanyl) 2nd injection: after 30 min: 2.5 mg bupivacaine + 5 ug fentanyl Patient had a hypo BP 06/04 regulated by filling 3rd injection 1 h 40 min: 2.5 mg bupivacaine + 5 ug fentanyl the trird, the forth an the the fifth patients were aged between 80 and 90 with a history of ischemic heart disease, hypertension, diabetes mellitus they were admited for hip fractures and were operated under CSA successfully.Conclusions CSA is a useful technique in high-risk patients (elderly patients with comorbidities). Its advantages are numerous: ease, and reliability.