To explore and analyze the effect of ropivacaine plus sufentanil for epidural anesthesia during abdominal surgery, a total of 120 patients who underwent abdominal surgery at our institution between May 2019 and November 2020 were recruited and randomly assigned at a 1:1 ratio to receive either ropivacaine alone for epidural anesthesia (control group) or ropivacaine plus sufentanil (observation group). The total anesthesia effect in the observation group was significantly higher than that in the control group (96.66% vs 78.33%) (P<0.05). The combined anesthesia resulted in significantly lower visual analogue scale (VAS) scores (1.51±0.84, 1.63±0.56, 1.69±0.63, 1.54±0.42) in patients at 4h, 8h, 16h and 24h postoperatively versus ropivacaine alone (2.35±0.88, 2.49±0. 69, 2.47±0.78, 2.39±0.58) (P<0.05). The Ramsay sedation score (RSS) scores (1.98±0.81, 2.44±0.62, 2.18±0.62, 2.51±0.37) of the observation group at 4h, 8h, 16h and 24h after operation were significantly lower than those of the control group (1.42±0.52, 1.73±0.71, 1.47±0.66, 1.68±0.62) (P<0.05). Patients receiving ropivacaine plus sufentanil were associated with a lower incidence of adverse reactions than those given ropivacaine only (5.00% vs 30.00%) (P<0.05). In abdominal surgery, ropivacaine plus sufentanil epidural anesthesia resulted in reduced postoperative pain, enhanced sedative effects and a lower risk of adverse reactions versus ropivacaine alone.