Objective To explore the effect of holistic nursing in operating room on reducing local anesthesia stress response in patients with plastic surgery. Methods A total of 88 patients who underwent plastic surgery in Weihai Maternal and Child Health Care Hospital from January 2016 to January 2020 were randomly divided into control group and observation group, with 44 patients in each group. The control group was given routine nursing, and the observation group was given holistic nursing in the operating room. The stress response indexes and cosmetic satisfaction of the two groups were compared. Results The mean arterial pressure and heart rate of the two groups at T1 and T2 were higher than those at T0, but those in the observation group were lower than those in the control group, the difference was statistically significant ( P <0.05). The scores of cosmetic satisfaction in the observation group were higher than those in the control group, and the differences were statistically significant ( P <0.05). Conclusion The application of holistic nursing measures in the operating room in patients with plastic surgery has a good effect, which can effectively improve the stress response of local anesthesia, improve the satisfaction of beauty, and is conducive to improving the effect of plastic surgery.