Abstract: AIM: To investigate myocardial toxicity of ropivacaine in elderly patients during epidural anesthesia. METHODS: Sixty elderly patients undergoing selective surgery were randomly divided into experimental group (ropivacaine) and control group (lidocaine). Blood samples were obtained from the 60 patients at different intervals to determine their AST, CK, CKMB and LDH. RESULTS: Significant differences were observed between groups in the values of myocardial enzymes before anesthesia and at the end of the surgery or 24 h after surgery (P<0.05), whereas the values of myocardial enzymes of the group of elderly patients were not significantly different between groups at the end of the surgery and 24 h after surgery. CONCLUSION: Compared with lidocaine, administration of ropivacaine has no greater myocardial toxicity during epidural anesthesia. The changes in myocardial enzymes of elderly patients may be mainly related to the surgery process.