Objective To explore the application efficacy of scalp nerve block combined with sevoflurane in craniotomy.Methods Fifty-five patients undergoing craniotomy in pingdingshan second people's hospital of henan province from Mar 2013 to Mar 2015 were randomly divided into observation group (n =28) and control group (n =27).The scalp nerve block combined with sevoflurane was performed in observation group and the sevoflurane intravenous inhalational combined with sufentanil was performed in control group.The changes of MAP and HR were observed before induction,5min after induction,skin incision,break the meninges,operation end and 5rmin after catheter removal.The agitation scale after operation,anesthesia duration,awaking time and dosage of sufentanil were compared.Restults MAP and HR at skin incision,break the meninges,operation end and 5min after catheter removal in control group were significantly increased than those before operation,and significantly higher than those in observation group at same stage of operation,with statistically significance differences (P ＜0.05).The agitation scale of observation group was lower than that of control group,with statistically significance difference (P ＜0.05).There was no significance difference between two groups in anesthesia duration (P＞0.05),the awaking time in observation group was significantly shorter than that in control group and the dosage of sufentanil was significantly reduced in observation group (P＜0.05).Corclusion Scalp nerve block combined with sevoflurane used in craniotomy has advantages in stable vital signs,rapid awaking,less dosage of sufentanil and lower score of agitation,which is suitable for clinical application.