Objective To observe the effect of remazolam combined with propofol in patients with rhinoplasty and its effect on body movement and respiratory depression during the perioperative period. Methods A total of 88 patients with rhinoplasty were selected in Nanpi County People's Hospital from June 2022 to February 2024, and they were divided into control group and observation group according to envelope method, with 44 patients in each group. The control group was treated with propofol for anesthesia, and the observation group was treated with remifentanil combined with propofol for anesthesia. The changes of vital signs [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP)] before anesthesia (T0), 10 min after anesthesia (T1) and 40 min after anesthesia (T2), anesthetic effect (anesthesia time, recovery time, leaving the monitoring room time), analgesic quality (VAS score), respiratory depression (respiratory frequency, respiratory obstruction) and body movement were compared between the two groups. Results There was no significant difference in HR, SBP and DBP between the two groups during T0 (P >0.05), while the levels of HR, SBP and DBP in the observation group during T1 and T2 were better than those in the control group (P <0.05). The anesthesia time, recovery time and leaving monitoring room time in the observation group were shorter than those in the control group (P <0.05). The VAS score of the observation group at 3,12 and 24 h after operation was lower than that of the control group (P <0.05). The respiratory rate of the observation group was higher than that of the control group after 1 min of anesthesia, and the number of respiratory tract obstruction was lower than that of the control group (P <0.05).The incidence of body movement in the observation group was 4.55%, which was lower than 9.09% in the control group, but the difference was not statistically significant (P >0.05). Conclusion Compared with the single application of propofol, the safety factor of combined application of remazolam is relatively higher, and the respiratory quality is better, the anesthetic effect is exact.