Objective: To explore the effectiveness of ultrasound-guided thoracic paravertebral nerve block (TPVB) combined with general anesthesia on postoperative analgesia following thoracoscopic surgery. Methods: Forty patients who underwent elective thoracoscopic surgery in our hospital were randomly divided into two groups of 20 patients each. The control group underwent general anesthesia plus postoperative intravenous analgesia, while the experimental group underwent general anesthesia combined with TPVB plus postoperative intravenous analgesia. The blood pressure and heart rate, as well as the dosage of intraoperative analgesic drugs were recorded at admission (T0), 30 min after the start of surgery (T1), immediately after the end of surgery (T2), and then at 1 h (T3), 6 h (T4), 24 h (T5) and 48 h (T6) after the end of surgery. The blood glucose concentration was measured at T0, T2, T5 and T6. The visual analogue score (VAS) was recorded at 1 h, 6 h, 12 h, 24 h and 48 h postoperatively at rest and during coughing. Patients were also observed for adverse events after surgery including nausea, vomiting and hematoma. Results: There were no significant differences in hemodynamic indexes or in the blood glucose concentration between the control and experimental groups (P > 0.05). The dosage of remifentanil in the experimental group was significantly lower than in the control group (P<0.05). The average VAS score at postoperative resting or coughing was significantly lower (P<0.05) for Group T than for Group G, except for the 1 h time for resting patients and 48 h time for coughing patients. (P < 0.05). Two patients in the control group experienced nausea but none in the experimental group. Conclusion: The application of TPVB combined with general anesthesia for thoracoscopic surgery can reduce the amount of analgesic drugs required during operation. This can provide a good postoperative analgesia effect and is thus worthy of clinical application.