The point that we should note about joint replacement surgery is that most of the people who are going to have joint replacement are over 40 years old and we need to do a cardiovascular evaluation before the operation. It is true that in most cases we use lumbar anesthesia and the patient is conscious and does not receive anesthesia, but in any case, every person who enters the operating room must undergo a cardiovascular evaluation and the risk level of the surgical treatment for him, according to the size or smallness of the surgery, should be evaluated and assessed by cardiologist colleagues, and finally the anesthesiologist should know what drugs he should use and how much.