Abstract: Objective To analyze the effects of epidural anesthesia combined with general anesthesia on hemodynamics, stress indicators, and emergence time in elderly colorectal cancer patients.Methods A total of 118 elderly colorectal cancer patients who underwent surgical treatment at Fuyang People's Hospital, from June 2023 to December 2024, were selected. The patients were randomly divided into two groups (n=59). Patients in the control group received general anesthesia, while those in the observation group underwent a combination of general anesthesia and epidural anesthesia. Both groups were compared for anesthetic effects.Results At 10 min after surgery and at the end of surgery, the observation group showed significantly lower heart rates and higher diastolic and systolic blood pressures than the control group (P<0.05). The observation group had significantly reduced cortisol and angiotensin II levels compared with the control group (P<0.05). At postoperative 48 h, the observation group showed remarkably lower alertness, sedation scores, and pain scores at rest than the control group (P<0.001). On postoperative day 3, the observation group showed remarkably lower sleep quality scores and fatigue scores, and higher cognitive dysfunction scores than the control group (P<0.001). The observation group had shorter emergence time and a lower number of patient-controlled analgesia (PCA) pump pressing than the control group (P<0.001). There were no statistically significant differences in terms of the incidence of adverse reactions between the two groups (P>0.05).Conclusions Epidural anesthesia combined with general anesthesia in elderly colorectal cancer surgery provides good anesthetic effects, which effectively maintains stable hemodynamics during surgery, reduces postoperative fatigue, improves sleep quality, and is relatively safe.