Abstract: Objective To compare the effect of combined spinal-epidural anesthesia of levobupivacaine and ropivacaine on postoperative respiratory function in elderly patients undergoing transurethral resection of prostate. Methods A total of 104 patients with prostatic hyperplasia were selected and divided into ropivacaine group and levobupivacaine group according to random number table method, with 52 cases in each group. The ropivacaine group was given 0.5% ropivacaine, and the levobupivacaine group was given 0.3% levobupivacaine for anesthesia. The conditions of sensory and motor blocks, hemodynamic changes before and after anesthesia, changes of respiratory function-related indicators and incidence rate of adverse reactions were compared between the two groups. Results The onset time of sensory and motor block in the ropivacaine group was longer than that in the levobupivacaine group, and the duration of sensory and motor block was shorter than that in the levobupivacaine group(P<0.05). There were no significant differences at different time points of anesthesia in the mean arterial pressure(MAP), heart rate(HR)and blood oxygen saturation(SpO₂)between the two groups(P>0.05). After anesthesia, the peak expiratory flow rate(PEFR)and forced expiratory volume in 1 second(FEV₁)in the ropivacaine group were significantly higher than those in the levobupivacaine group(P<0.05). The total incidence rate of adverse reactions in the ropivacaine group was significantly lower than that in the levobupivacaine group, but no significant difference was - found in two groups(P>0.05). Conclusion Combined spinal-epidural anesthesia of ropivacaine for elderly patients undergoing transurethral resection of prostate has faster motor recovery, less effects on respiratory system and higher safety.