OBJECTIVE：  To investigate the effect of combined spinal epidural anesthesia and peripheral nerve block on stress response of patients with hypertension in lower limb surgery. METHODS：  96 patients underwent selective unilateral lower limb surgery were randomly dived into trial group and control group with 48 cases in each group. the trial group was given Ropivacaine hydrochloride injection 15-25 ml for peripheral nerve block， and the trial group was given Bupivacaine hydrochloride injection 1.2-1.8 ml for  combined spinal epidural anesthesia. The operation time， the onset time of anesthesia and the time of block improvement were observed in 2 groups， and HR， MAP， SpO2， E， NE， IL-6 and COR were also observed before operation （T0）， at the moment of incision （T1）， during operation （T2） and at the moment of extubation after surgery （T3）. RESULTS： The onset time of anesthesia and the time of block improvement in control group were significantly lower than in trial group， with statistical significance （P＜0.05）. There was no statistical significance in HR and SpO2 between 2 groups at  T0， T1， T2 and T3 （P＞0.05）； MAP of control group was significantly lower than that of trial group at  T1 and T2， T3， with statistical significance （P＜0.05）. There was no statistical significance in E， NE， IL-6 and COR of 2 groups at T0 （P＞0.05）； E， NE， IL-6 and COR of trial group were significantly higher than those of control group at T1， T2 and T3 （P＜0.05）. CONCLUSIONS： The effect of combined spinal epidural anesthesia is weaker than peripheral nerve block on  the circulation fluctuation and stress response of patients with hypertension in lower limb surgery， showing good anesthesia effect.