Objective To explore the effect of whole-course psychological nursing in operating room on relieving tension in patients undergoing double eyelid surgery. Methods A total of 80 patients who underwent double eyelid surgery in our hospital from May 2023 to February 2024 were randomly divided into control group and study group, with 40 patients in each group. The control group only received routine nursing, and the study group added whole-course psychological nursing on the basis of routine nursing. The changes of vital signs, psychological state, pain and satisfaction were compared between the two groups. Results The systolic blood pressure, diastolic blood pressure and heart rate of the study group were lower than those of the control group at 10 min after the surgery (P <0.05). The scores of anxiety, depression and fear in the study group were lower than those in the control group at the end of surgery (P <0.05). The proportion of mild pain in the study group was higher than that in the control group, and the proportion of moderate and severe pain was lower than that in the control group (P <0.05). The satisfaction of the study group was higher than that of the control group (P <0.05). Conclusion The whole-course psychological nursing in the operating room can effectively alleviate the tension of patients with double eyelid surgery, improve the satisfaction of surgical patients, and play a positive role in improving the psychological state of surgical patients.