Objective To investigate the effect of ultrasound-guided continuous paravertebral nerve block (PVNB) on postoperative analgesia, stress and inflammatory factors in elderly patients with esophageal cancer undergoing thoracotomy. Methods 90 patients with oesophagus cancer undergoing thoracotomy under general anesthesia were selected as the subjects of study. 45 patients were given PVNB anesthesia combined with general anesthesia (PVNB group) and 45 patients in the control group before operation under the guidance of ultrasound. Patients in the two groups were given intravenous self controlled analgesia (control group) after operation. Patients in the two groups were compared in resting state at 2h, 6h, 24h and 48h after operation The visual analogue pain score (VAS) in the state of coughing and coughing, the dosage of analgesics and adverse reactions of analgesics after operation, the differences of NE, e, cor, IL-6, TNF - α in serum before and 24 hours after operation, and the occurrence of pulmonary infection after operation. Results there were significant differences between the two groups (P < 0.05), and the two groups (P > 0.05). In PVNB group, the number of postoperative analgesia pump press and sufentanil dosage were lower than those in the control group (P < 0.05), while in PVNB group, the number of postoperative analgesia pump press and sufentanil dosage were lower than those in the control group (P < 0.05). There was no statistical significance between the two groups in serum ne, e and cor levels (P > 0.05); the serum ne, e and cor levels in the two groups were higher than those before operation (P > 0.05) The serum levels of NE, e and cor in PVNB group were lower than those in the control group (P < 0.05) 24 hours after operation, and there was no significant difference in the serum levels of IL-6 and TNF - α between the two groups before operation (P > 0.05); the serum levels of IL-6, IL-10 and TNF - α in PVNB group were higher than those before operation (P < 0.05), the serum levels of IL-6 and TNF - α in PVNB group were lower than those in the control group (P < 0.05), and the postoperative pulmonary infection in PVNB group was 2 The incidence of pulmonary infection in PVNB group was lower than that in control group (P < 0.05). Conclusion ultrasound-guided PVNB can improve the postoperative analgesia effect of elderly patients with esophageal cancer, reduce the stress response caused by surgical trauma, and reduce the incidence of postoperative pulmonary infection.