Objective To investigate the effect of nonintubated intravenous anesthesia combined with local anesthesia on sympathetic nerve chain resection. Method One hundred and sixty palmar hyperhidrosis patients undergoing sympathetic nerve chain resection were divided into two groups, intubation general anesthesia (IGA) group and nonintubated intravenous anesthesia (NIA) group. The patients in IGA group were administrated with intubation general anesthesia. The patients in NIA group were administrated with nonintubated intravenous anesthesia. The physical signs, general anesthetics dosage, anesthesia time, hospital stays, hospitalization costs and postoperative complications were compared between two groups. Results In NIA group, the MAP after anesthesia , HR at 5 min and 10 min after anesthesia were lower than those in IGA group :MAP: (65.83 ± 12.53) , (68.19 ± 9.56), (69.72 ± 8.44), (68.58 ± 13.42) mmHg(1 mmHg = 0.133 kPa) vs. (98.47 ± 13.59), (93.53 ± 10.16), (86.13 ± 11.22), (81.52 ± 9.67) mmHg; HR:(76.36 ± 7.93), (78.42 ± 9.13) bpm vs. (102.67 ± 10.38), (97.66 ± 9.73) bpm, P<0.05. Similarly, the SpO2 and PaO2 after anesthesia in NIA group were also lower than those in IGA group:SpO2:0.93 ± 0.14, 0.94 ± 0.21, 0.93 ± 0.34, 0.94 ± 0.24 vs. 1.00 ± 0.13, 0.99 ± 0.16, 0.99 ± 0.20, 0.98 ± 0.13; PaO2: (83.73 ± 8.35), (68.57 ± 9.32), (63.93 ± 10.54), (65.51 ± 11.72) mmHg vs. (298.65 ± 25.19), (328.58 ± 30.61), (303.26 ± 29.34), (317.49 ± 28.15) mmHg , P<0.05. And the PaCO2 after anesthesia was higher than that in IGA group (52.93 ± 9.27), (61.47 ± 7.32), (71.58 ± 8.23), (68.13 ± 10.58) mmHg vs. (36.86 ± 5.52), ( 35.73 ± 6.14), (37.18 ± 7.39), (36.35 ± 5.87) mmHg, P<0.05. In NIA group, the dosages of propofol and remifentanil, anesthesia time were less than those in IGA group:(235.63 ± 19.42) mg, (446.58 ± 50.32)μg, (66.45 ± 13.35) min vs. (317.86 ± 28.36) mg, (623.47 ± 403.93)μg , (89.27 ± 16.38) min, P<0.05 or<0.01. In hospital stays, hospitalization costs, there were no significant differences between two groups (P>0.05). In NIA group, 8 patients needed artificial respiration, which were more than those in IGA group (8 vs. 0) (P<0.05). In NIA group, the incidences of throat discomfort, nausea and vomiting were lower than those in IGA group:0 vs. 32.5% (26/80) and 25.0% (20/80) vs. 11.2% (9/80), P<0.05. However, the incidence of lung infection was similar to that in IGA group (P>0.05). Conclusions Nonintubated intravenous anesthesia combined with local anesthesia is safe for palmar hyperhidrosis patients undergoing sympathetic nerve chain resection, with less complications and without increasing the workload.