To investigate the effects of ropivacaine combined with parecoxib sodium used in laparoscopic gynecological surgery of elderly patients on their postoperation pain and cognitive function. Methods: 102 elderly patients who were scheduled to undergo laparoscopic gynecological surgery between October 2017 and November 2019 were selected and randomly divided into control group and observation group (51 cases in each group). After induction of anesthesia, the patients in the observation group were given 40 mg of parecoxib sodium intravenously before surgery, and the patients in the control group were given normal saline intravenously before surgery. The patients in both groups were given 10ml of 0.5% ropivacaine for local infiltration incision around each laparoscopic operation hole before establishing pneumoperitoneum, and were given 10ml of 0.5% ropivacaine to spray the pelvic cavity before removing the perforator at the end of surgery. The general conditions of surgery, degree of pain at different time points after surgery, quality of anesthesia recovery immediately and at 5 min after extubation, cognitive function before surgery and at 24h and 72h after surgery, and adverse reactions rate of the patients were compared between the two groups. Results: There were no significant differences in extubation time, eyeopening time, anesthesia time, and operation time of the patients between the two groups (P>0.05). The number of pressing of controlled intravenous analgesia pump (PCA) of the patients in the observation group was significant less than that of the patients in the control group. Visual analogue score (VAS) as the chief complaints of the patients in the observation group at 1h, 2h, 4h, 8h, or 12h after surgery was significant lower than that of the patients in the control group (P<0.05). The score of agitation immediately after extubation of the patients in both groups was significant lower than that 5min after extubation. Ramsay sedation score of the patients in both groups was significant higher than that 5min after extubation, and which variation range of the patients in the observation group was significant more than that of the patients in the control group (all P<0.05). The mini mental status examination (MMSE) score of the patients in the two groups at 24h and 72h after surgery had decreased significantly (P<0.05), which of the patients in the two groups at 72h after surgery was significant higher than that at 24h after surgery (P<0.05), and which of the patients in the observation group at 24h and 72h after surgery were significant higher than those of the patients in the control group (all P<0.05). The incidence (9.8%) of postoperative cognitive function disorder (POCD) within 72h after surgery of the patients in the observation group was significant lower than that (25.5%) of the patients in the control group (P<0.05). The total incidence rate of adverse reactions (9.8% vs. 7.8%) of the patients had no significant different between the two groups (P>0.05). Conclusion: Ropivacaine local block combined with parecoxib sodium preemptive analgesia used in laparoscopic gynecological surgery of elderly patients has good postoperative analgesic effect, which can improve the quality of anesthesia recovery and reduce POCD with good safety.