To study the anesthetic effect of oxycodone hydrochloride in painless fiberoptic bronchoscopy anesthesia. Methods 85 patients who underwent fiberoptic bronchoscopy from May 2021 to March 2022 were randomly divided into control group (sufentanil+propofol, n=42) and experimental group (oxycodone hydrochloride+propofol, n=43). The perioperative hemodynamic indexes, perioperative cough and agitation scores, postoperative sedation and pain scores were recorded, and the intraoperative anesthetic dosage and incidence of adverse events were recorded, and the satisfaction of patients and operators was evaluated. Results The baseline of the two groups was the same. The times of sufentanil administration in the experimental group was significantly less than that in the control group, but the recovery time in the experimental group was significantly longer than that in the control group (P＜0.01). The heart rate and mean arterial pressure were significantly increased when the fiberoptic bronchoscope passed through the tracheal carina or stenosis (T3), and they were significantly higher in control group than those of the experimental group (P＜0.05). The scores of cough and agitation in the experimental group were significantly lower than those in the control group (P＜0.05). The cough score, Ramsay score and visual analogue scale (VAS) score of the experimental group were significantly lower than those of the control group (P＜0.05), and the VAS score of half an hour after operation was still significantly lower than that of the control group (P＜0.05). There was no significant difference in the incidence of adverse events between the two groups, but the satisfaction of both patients and operators in the experimental group was significantly higher than that in the control group (P＜0.05). Conclusion Oxycodone hydrochloride has better analgesic effect and more stable hemodynamics than sufentanil during fiberoptic bronchoscopy, it significantly reduced patients' agitation, cough and administration of anesthetics during operation, and significantly improved satisfaction of both patients and operators.