Ｏｂｊｅｃｔｉｖｅ　To investigate the effect of general anesthesia combined with stellate ganglion block(SGB) on the perioperative function of autonomic nerve in old patients with hypertension.　Methods　One hundred and twenty old patients with hypertension undergoing selective laparoscopic radical gastrectomy, age 60-85 years old, ASA Ⅰ-Ⅲ, in the department of general surgery, during September, 2014 to December, 2016 were enrolled. Patients were randomly assigned to control(C group, n=40), left SGB(LSGB group, n=40) and right SGB group (RSGB group, n=40) by random number table method. An ultrasound guided single spot of left or right SBG procedure by using 7 ml of 0.2% ropivacaine was performed before the induction in LSGB or RSGB group, respectively. SBP, DBP, and HR were monitored at the moment of entering operating room(T1), 5 min after SGB(T2), induction of general anesthesia(T3), intubation(T4), 5 min after intubation(T5), pneumoperitoneum(T6), exploration(T7), waking up(T8), extubation(T9), 5 min after extubation(T10), 2 h(T11), 12 h(T12) and 24 h(T13) after the surgery. Heart rate variability (HRV) including low frequency(LF), high frequency(HF), total power(TP), and the ratio of LF/HF during a 5-min period of the moments mentioned above was recorded and analyzed by using holter monitor. SGB-related adverse effects and perioperative cardiovascular events were recorded. Area under curve(AUC) was used to analyze the perioperative function of autonomic nerve.　Results　Perioperative change of SBP, DBP, and HR in both LSGB and RSGB group were smaller than that in C group(P<0.05). There was no significant difference of perioperative change of SBP and DBP between LSGB and RSGB group(P>0.05), while the change of HR in LSGB group was larger than RSGB group (P<0.05). Perioperative change of LF and the ratio of LF/HF were smaller, as well as TP and HF were larger in both LSGB and RSGB group than that in C group (P<0.05). There was no significant difference of perioperative change of LF, HF, TP and the ratio of LF/HF between LSGB and RSGB group(P>0.05). All the incidence of SGB-related adverse effects and perioperative cardiovascular events was similar(P>0.05).　Conclusions　Both left and right SGB are benefit for the old patients with hypertension on perioperative function of autonomic nerve.