Objective:To explore the effect of combined use of esketamine and ropivacaine in ultrasound-guided axillary brachial plexus block(BPB).Methods:A retrospective analysis was conducted on the clinical data of 130 patients.They were di-vided into the control group(64 cases receiving general anesthesia)and the observation group(66 cases receiving ultrasound-guided axillary BPB with esketamine and ropivacaine on the basis of general anesthesia)according to different anesthesia meth-ods.The pain,postoperative condition,hemodynamic indices,and adverse reactions were compared between the two groups.Re-sults:The Visual Analog Scale(VAS)scores of both groups reached the highest at 12 h postoperatively and then decreased over time,and the observation group was lower than the control group(P<0.05).Inter-group comparisons found that postoperative extubation time and awakening time of the observation group were shorter.The time of using patient-controlled intravenous an-algesia(PCIA)for the first time was longer,and effective compressions were fewer in the observation group(P<0.05).The incidence of dizziness in the observation group was higher(P=0.033).There was no statistically significant difference in the o-verall incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combined use of esketamine and ropi-vacaine can achieve good analgesic and postoperative effects,without influence on patient hemodynamics or increase in postoper-ative adverse reactions.It can be used for clinical promotion.