Objective：To evaluate the effects of combined use of oxycodone and propofol for total intravenous anesthesia in patients with breast cancer undergoing breast-conserving surgery，on the intraoperative anesthesia，perioperative adverse reactions and analgesic effects. Methods：Eighty patients elective undergoing breast-conserving surgery for breast cancer，with American Society of Anesthesiologists（ASA）physical status classification Ⅰ or Ⅱ，aged 26-61 year，and body mass index（BMI）of 19~28 kg/m² ，were randomly divided into oxycodone group（n=40）and fentanyl group（n=40）. The systolic blood pressure（SBP），diastolic blood pressure （DBP），and heart rate（HR）were recorded at the following time points：before anesthesia induction（T₀），immediately before tracheal intubation（T₁），at the start of surgery（T₂），during resection of the breast specimen（T₃），and at the end of surgery（T₄）. The numerical rating scale（NRS）for pain were recorded at rest and during movement at 2 h，6 h，24 h and 48 h after surgery. The time to awakening， extubation time，and propofol consumption were also recorded. The incidence of cough reflex during induction，intraoperative awareness，intraoperative hypotension，postoperative agitation，nausea and vomiting，and skin itching were observed in both groups. Results：At T₂ and T₃，the SBP，DBP and HR in the oxycodone group were significantly higher than those in the fentanyl group（P < 0.05）. The NRS scores for resting pain and movement pain at 2 h after surgery were significantly lower in the oxycodone group than the fentanyl group（P < 0.05）. The incidence of cough reflex during induction was significantly lower in the oxycodone group than in the fentanyl group（P < 0.05）. Conclusion：Oxycodone combined with propofol for total intravenous anesthesia can be safely used in breast- conserving surgery for breast cancer. It provides satisfactory anesthesia induction and maintenance，has minimal impact on circulation during surgery，and has effective postoperative analgesic effects.