OBJECTIVE: To discuss the effect and safety of dezocine on hemodynamics and inflammatory cytokines in esophageal cancer patients with one-lung ventilation (OLV). METHODS: 80 esophageal cancer patients were randomly divided into observation group and control group, 40 cases in each group. All patients received 0.5 mg penehyclidine hydrochloride+0.1 mg/kg midazolam+4 μg/kg fentanyl+2 mg/kg propofol+0.15 mg/kg cisatracurium for anesthesia induction, propofol 4-10 mg/(kg·h) + remifentanil 0.1 μg/(kg·min) were pumped after double-lumen endobronchial catheter. Observation group received 1 mg dezocine by Intravenous injection in surgical skin incision, control group received the same amount of normal saline. Hemodynamic parameters [heart rate (HR), mean arterial pressure (MAP)] and inflammatory cytokine levels in 2 groups before anesthesia induction (T1), when skin incision (T2), 5 min after dezocine/normal saline (T3), OLV 30 min (T4), recovery two-lung ventilation 10 min (T5) and end of the operation (T6) were compared, and the incidence of adverse reactions was observed. RESULTS: There was no significant difference in HR and MAP in 2 groups at T1, T5 and T6 (P>0.05); HR and MAP in observation group at T2, T3 and T4 were significantly lower than control group, the difference was statistically significant (P<0.05). There were no significant differences in TNF-α and IL-8 at T1, T2 and T3 and IL-6 at T1, T2, T3 and T4 between 2 groups (P>0.05); TNF-α and IL-8 at T4, T5 and T6 and IL-6 at T5 and T6 in observation group were significantly lower than control group, the differences were statistically significant (P<0.05). And there was no obvious adverse reactions during treatment. CONCLUSIONS: Dezocine shows more stable hemodynamics and lower expression level of inflammatory cytokines in esophageal cancer patients with OLV, with good safety.