Objective To analyze the effect of paravertebral block (PVB) combined with general anesthesia on stress response indexes in patients undergoing abdominal liposuction surgery. Methods A total of 86 patients scheduled for elective abdominal liposuction surgery admitted to the Third People's Hospital of HubeiProvince from June 2023 to June 2025 were selected. According to the random number table method, they were divided into the control group and the study group, with 43 patients in each group. The control group was treated with general anesthesia, and the study group was treated with paravertebral block combined with general anesthesia. The stress response indexes, anesthetic dosage, recovery time, analgesic effect and sedative effect were compared between the two groups. Results At 2 hours after surgery, the levels of Cor, NE and Ang Ⅱ in the study group were all lower than those in the control group (P<0.05). The dosages of propofol and remifentanil in the induction and maintenance periods of the study group were lower than those of the control group (P<0.05). The extubation time, post-anesthesia care unit stay time, spontaneous breathing recovery time and awakening time in the study group were all shorter than those in the control group (P<0.05). At 6, 12 and 24 hours after surgery, the scores of VAS of resting and coughing in the study group were lower than those in the control group (P<0.05). At 6, 12 and 24 hours after surgery, the scores of Ramsay sedation in the study group were lower than those in the control group (P<0.05). Conclusion Paravertebral block combined with general anesthesia for patients undergoing abdominal liposuction surgery can effectively reduce the body's stress response, decrease the dosage of general anesthetics, shortenpostoperative awakening time and recovery time, and is conducive to improving analgesic and sedative effects.