ABSTRACT: Objective To investigate the efficacy of ultrasound-guided sacral block combined with laryngeal mask general anesthesia in children undergoing hypospadias surgery. Methods A total of 100 children undergoing hypospadias surgery in our hospital were randomly divided into sacral block combined with general anesthesia group (GC group) and general anesthesia group (G group), with 50 cases in each group. All children underwent laryngeal mask anesthesia, GC group underwent ultrasound-guided sacral block after laryngeal mask anesthesia. The operative heart rate (HR), mean arterial pressure (MBP), pressure of end-tidal carbon dioxide partial pressure (PETCO2), and the consumption of intraoperative general anesthetic drug were recorded in the two groups. The heart rates, FLACC scores and the Ramsay sedation scores at 15min, 30 min, 45 min and 60 min in PACU were also recorded. In addition, the use of tramadol and the cases of painful penile erection at 24 h after operation were also collected. Results There was no significant difference in HR, MBP and PETCO2 between the two groups at each intraoperative time point (P>0.05); The amount of general anesthesia in GC group was less than that in G group, and the difference was statistically significant (P<0.05). Compared with G group, the FLACC pain score and heart rate in GC group were lower at the corresponding time points of 15, 30, 45 and 60 min in PACU (P<0.05), while the Ramsay sedation score was higher at the corresponding time points of 30, 45 and 60 min after admission to PACU (P<0.05), and there were fewer cases of tramadol relief analgesia and painful erection 24 h after operation (P<0.05). No complications related to nerve block such as puncture site infection, hematoma and local anesthetic poisoning were observed in GC group. Conclusion Compared with simple laryngeal mask general anesthesia, ultrasonic-guided sacral block combined with laryngeal mask general anesthesia has better sedation and analgesia effect in early postoperative period in children with hypospadias.