【Abstract】Objective To evaluate the effects of ropivacaine combined with dexmedetomidine for erector spinae plane block (ESPB) on postoperative analgesia and recovery in patients undergoing daytime-pattern laparoscopic adrenalectomy. Methods A total of 60 patients undergoing daytime-pattern laparoscopic adrenalectomy under general anesthesia, American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ, were selected. According to the random number table method, they were divided into two groups (n=30): a ropivacaine group (group R) and a ropivacaine combined with dexmedetomidine group (group RD). All patients in two groups were treated with unilateral and single ESPB under ultrasound guidance before extubation. Patients in group R were injected with 30 ml of 0.5% ropivacaine, while those in group RD were injected with 1 μg·kg-1 dexmedetomidine combined with 30 ml of 0.5% ropivacaine. The consumption of sufentanil in analgesia pump within 48 h postoperatively were recorded. Visual Analogue Scale (VAS) scores at rest and during coughing at postoperative 1, 6, 12, 24 and 48 h, the first postoperative analgesic time and rescue doses of flurbiprofen axidate, the QoR-15 scores at 24 h preoperatively and at 24 h and 48 h postoperatively, I-FEED scores at postoperative 12, 24, 48 h were recorded. Besides, the time of first postoperative flatus and defecation and the incidence of adverse events within 48 h after surgery were also recorded. Results The sufentanil consumption and rescue doses of flurbiprofen axetil in the group RD were lower than those in the group R within 48h postoperatively(P0.05), and the first postoperative analgesic time in the group RD was significantly longer than those in the group R (P0.001). The VAS scores at postoperative 6, 12, 24 and 48 h at rest and at 6, 12 and 24 h postoperatively during coughing in the group RD were all lower than those in the group R(P0.05). The QoR-15 scores at postoperative 24 h and 48 h were significantly higher in the group RD than those in the group R(P0.05), and I-FEED scores at 12, 24, and 48 h postoperatively in the group RD were lower than those in the group R(P0.05), and the time of first postoperative flatus and defecation were earlier in the group RD than those in the group R(P0.05). Conclusions Ropivacaine combined with dexmedetomidine for ESPB reduces postoperative consumption of sufentanil, prolongs the time to first rescue analgesia, decreases postoperative pain scores, improves postoperative gastrointestinal function and recovery quality, promotes rapid postoperative recovery in patients undergoing daytime-pattern laparoscopic adrenalectomy.