To explore the protective effect of Dexamethasone (DXMS) combined with Ropivacaine (ROP) on hemodynamics, stress state and myocardial function in patients after thoracoscopic surgery.Methods A total of 64 patients who underwent minimally invasive thoracoscopic thoracotomy in our hospital were collected for prospective non-randomized controlled experiments.28 patients were treated with ROP anesthesia during the operation and were regarded as the control group.The other 36 patients were treated with DXMS combined with ROP anesthesia during the operation regarded as a study group.The vital signs, hemodynamic markers, plasma epinephrine (E), norepinephrine (NE) levels, inflammatory factor levels, myocardial injury markers, cardiac fatty acid-binding protein levels in the two groups were observed, and the occurrence of postoperative adverse reactions was counted.〖WTHZ〗Results The fluctuations of Mean arterial pressure (MAP) and Heart rate (HR) in the study group were lower than those in the control group (P＜0.05).The levels of Peripheral capillary oxygen saturation (SpO2), Oxygenation index (OI) and Pressure of oxygen (PaO2) in the study group were higher than those in the control group after anesthesia, after intubation, and during extubation (P＜0.05).During the process, the levels of E, NE, Macrophage inflammatory protein I (MIP-1), Interleukin-6 (IL-6) and Tumor necrosis factor alpha (TNF-α) in the two groups gradually increased, but the research group was lower than the control group (P＜0.05).After operation, the levels of Creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI) and Heart type-Fatty acid binding protein (H-FABP) in the two groups were decreased, and the research group was lower than the control group (P＜0.05).Finally, there was no difference in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion DXMS combined with ROP can effectively reduce myocardial injury, inflammatory factors and stress state in patients after thoracotomy, and can effectively improve hemodynamics, which is worthy of clinical promotion