Objective: To investigate the effect of serratus anterior plane block (SAPB) combined with general anesthesia on analgesic effect, inflammatory cytokines and early recovery in patients undergoing thoracoscopic lobectomy. Methods: A total of 240 patients undergoing thoracoscopic lobectomy were selected and randomly divided into control group (n=120) and SAPB group (n=120). SAPB group received ultrasound-guided SAPB (0.375% ropivacaine 20 mL) before induction of anesthesia. Both groups were given remifentanil and propofol to maintain anesthesia, and postoperative patient-controlled intravenous analgesia was given. The VAS scores, perioperative opioid dosage, remedial analgesia rate and postoperative recovery at 6, 12, and 24 h after operation, and 24 h at rest and under coughing state were recorded in the 2 groups. The levels of serum interleukin-6 (IL-6), IL-1β and tumor necrosis factor-α (TNF-α) before and after operation were detected in the 2 groups, and the adverse reactions were statistically analyzed. Results: Compared with the control group, the VAS scores at rest and cough within 24 h after operation in the SAPB group were significantly decreased (P<0.05), and the intraoperative remifentanil dosage, postoperative sufentanil dosage and remedial analgesia rate were significantly decreased (P<0.05). The extubation, ambulation, anal exhaust and postoperative hospital stay were significantly advanced in the SAPB group (P<0.05), the indwelling time of closed thoracic drainage tube was significantly shortened (P<0.05). At 24 h after operation, the levels of IL-6, IL-1β and TNF-α in the 2 groups were higher than those before operation (all P<0.05). Compared with the control group, the levels of IL-6, IL-1β and TNF-α in SAPB group were lower (P<0.05). The incidence of nausea, vomiting and pruritus in SAPB group was significantly lower than that in the control group(P<0.05). Conclusion: SAPB combined with general anesthesia can improve the postoperative analgesic effect of thoracoscopic lobectomy, inhibit inflammatory stress response and promote early postoperative recovery.