To explore the effects of ketorolac tromethamine combined with propofol on the perioperative surgical stress, uterine contraction pain, and positive and negative affectivities of the patients who wanted painless artificial abortion. Methods: Totally 158 patients who voluntarily wanted painless abortion were included and were randomly divided into control group and observation group (79 cases in each group) from June 2019 to June 2020. The patients in the control group were given an intravenous bolus of 2.0 mg/kg of propofol, and the patients in the observation group were given intravenous infusion 30 mg of ketorolac tromethamine at 30 min before surgery and then intravenous bolus of 2.0 mg/kg of propofol within 1 min before the start of the abortion. The values of the surgery-related indicators, the vital signs indicators, such as heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), blood oxygen saturation (SpO2) of the patents before anesthesia (T0), at cervical dilation (T1), at the end of surgery (T2), at 10 min after surgery (T3), and at 30 min after surgery (T4), and the perioperative surgical stress indicators, such as cortisol (Cor), angiotensin-II (Ang-II), norepinephrine (NE), and adrenocorticotropic hormone (ACTH), the degree of uterine contraction pain after abortion, the positive and negative affectivity scores (PANAS) after abortion, and the rate of adverse reactions of the patients were compared between the two groups. Results: There were no significant differences in the operative time and the postoperative recovery time of the patients between the two groups (P>0.05). The amount of intraoperative propofol used of the patients in the observation group was significantly lower than that of the patients in the control group (P<0.05). There were significant differences in the values of HR, MAP, and SpO2 of the patients at different time points of the abortion between the two groups (P<0.05), but there were no significant differences in the values of HR, MAP and SpO2 of the patients in the observation group among different time points of the abortion, of the patients in the control group among different time points, or of the patients in the two groups among different time points (P>0.05). There was significant difference in the RR value of the patients between the two groups. There was significant difference in the RR value of the patients in the observation group, in the control group, or in the two groups among different time points. There was significant difference in the RR value of the patients at different time points between the two groups (P<0.05). The HR value of the patients in the observation group at T1, T2, T3, or T4 had significantly different from that of the patients in the control group. The values of Cor, Ang-Ⅱ, NE, and Co of the patients in the observation group at T1, T2, or T3 had significantly lower than those of the patients in the control group (all P<0.05). VAS scores of uterine contraction pain of the patients in both groups at T0, T1, T2, T3, and T4 showed a trend of increasing and then decreasing from T0 to T4, and which of the patients in the observation group were significantly lower than those of the patients in the control group (P<0.05). At T4, the positive affectivities score of the patients in both groups had increased significantly after surgery, the negative affectivities score of the patients in both groups had decreased significantly after surgery, and the change ranges of which of the patients in the observation group were significantly more than those of the patients in the control group (both P<0.05). There was no significant difference in the total incidence of adverse reactions (8.9% vs.11.4%) of the patients between the two groups (P>0.05). Conclusion: Ketorolac tromethamine combined with propofol used in painless abortion can reduce the dosage of intraoperative propofol, have little influence on the hemorheology and stress response indicators of the patients, and which can effectively reduce the postoperative uterine contraction pain degree and improve the PANAS scores.