Abstract： Objective To compare the effect and stress reaction of preoperative intravenous injection of analgecine and complications of patient-controlled intravenous analgesia( PCA )of different doses of fentanyl in postoperative total hysterectomy patients. Methods 120 patients underwent total hysterectomy in general anesthesia were randomly divided into three groups with forty cases each. 7.2 U mg in group A ,0.5 mg in group B, fentanyl 0.5 mg in group C. Besides, patients in group C were injected with Analgecine at night before the operation, preoperation and postoperation respectively. The visual analog scale(VAS), times of PCA, patient's satisfaction were recorded during the period of postoperative 48 hours. Results The VA$ of group B at 2 hours after operation was significantly higher than that of group A and C (P＜0.05 ), which became similar 2 hours later(P ＞ 0.05). The patient's satisfaction in group B was significantly lower than that in group A and C(P＜0.05). At 4 hours after operation, the concentrations of cortisol and β-endorphin in three groups were significantly higher than those of cortisol and β-endorphin at 1 hours before operation(P＜0.05);the concentrations at 16 hours after operation in group A and group B were also significantly higher than those in group C(P＜0.05). At 48 hours after operation, there showed no statistical differences in the concentrations among the three groups, and the concentrations did not significahtly differ from those before operation. Conclusion Preoperative intravenous injection of analgecine has a better effect on patient-controlled intravenous analgesia(PCIA) of fentanyl and can reduce fentanyl requirement and stress reaction in total hysterectomy patients.