【Abstract】Objective To investigate the effect of modified general anesthesia and transverse abdominis plane block on the pain management and cognition of obesity patient undergoing laparoscopic sleeve gastrectomy surgery. Methods 80 obese patients who were selected by general anesthesia selective sleeve gastrectomy in the Second Affiliated Hospital of Anhui Medical University from November 2018 to December 2019 were divided into general anesthesia group (GA group) and general anesthesia combined TAPB group (GA + TAPB group), each group 40 cases. Peripheral venous infusion load of dextrometramidine (2 μg〖DK〗·kg-1〖DK〗·h-1 for 15 min, anesthesia was induced by vein and maintained by sevoflurane inhalation. The postoperative analgesia was performed by automatic intravenous analgesia pump. TAPB was used to guide the horizontal block of abdominal transverse muscle under bilateral costal margin by ultrasound (0375% ropivacaine plus 1 μg 〖DK〗· kg "right metomidine"). The operation room (T0), heart rate (HR), mean arterial pressure (MAP), SpO2, Hamilton Depression Scale (HAMD), Hamilton Depression Scale (HAMD), and T2 after sleeve gastrectomy and T3 MOCA scale and AVLT were used to evaluate the scores. The anesthesia time, operation time, T4, 75 hours after PACU, TB and vas were recorded one to three days after operation to evaluate the analgesic effect and observe the recovery after operation. Result There was no significant difference in general information and preoperative HAMA, HAMD, MOCA and AVLT scores between the two groups (P＞005). Compared with GA group, the dosage of propofol and remifentanil in GA+TAPB group decreased significantly (P＜005), mean arterial pressure (map) and heart rate (HR) decreased significantly (P＜005), VAS score decreased significantly at T4, T5, the first day and the second day after operation (P＜005). The number of patients requiring salvage analgesia on the third day after operation decreased significantly (P＜005). There were significant differences in MOCA and AVLT delay scores between GA+TAPB group and preoperative group (P＜005). Conclusion The combination of general anesthesia and TAPB could provide more stable anesthesia and better postoperative pain management, and may also have positive effect on the cognitive function and instantaneous delay memory of obesity patients.