Objective To investigate the effect of continuous thoracic paravertebral nerve block (TPVB) as anesthesia and analgesia on perioperative hemodynamics and recovery quality in patients undergoing laparoscopic nephrectomy. Methods The clinical data of 98 patients who underwent laparoscopic nephrectomy in the hospital from February 2018 to June 2021 were analyzed retrospectively. Patients undergoing general anesthesia and those undergoing continuous TPVB were included in the control group (n=49) and the observation group (n=49), respectively. Operation related indicators, perioperative hemodynamic indexes at different time points ［when entering the operating room(T0), after 3 minutes of anesthesia induction(T1), at the beginning of operation (T2), at the end of operation (T3), when leaving the operating room(T4)］, recovery quality, pain degree, and adverse reactions were compared between groups. Results The operation-related indicators in the two groups were similar (P＞0.05). There were statistically significant differences in mean arterial pressure (MAP)and blood oxygen saturation in terms of time effect, inter-group effect and interaction effect(P＜0.05). The two groups had significantly different MAP at T1-T4 (P＜0.05). MAP at T0,heart rate (HR) and blood oxygen saturation at T0-T4 showed no significant difference between groups (P＞0.05). Ramsay sedation scores and Steward recovery scores of the observation group were higher than those of the control group (P＜0.05). The classification of emergence agitation in the two groups was similar (P＜0.05). There were statistically significant differences in Visual Analogue Scale (VAS) scores of both groups in resting state and motion state in terms of time effect, inter-group effect and interaction effect(P＜0.05). The VAS scores of the observation group in resting state and motion state at 12h and 24h after operation were lower than those of the control group (P＜0.05). There was no statistically significant difference in VAS score between the two groups at 6h and 48h after operation(P＞0.05).The postoperative adverse reactions in the two groups included respiratory suppression, nausea and vomiting, pruritus, chills, and insufficient analgesia. The incidence of adverse reactions showed no significant difference between groups (P＞0.05). Conclusion Applying continuous TPVB as anesthesia and analgesia for patients undergoing laparoscopicnephrectomy can significantly improve perioperative hemodynamics and recovery quality, and alleviate pain, without increasing the incidence of adverse reactions