Objective To explore the effect of ropivacaine local anesthesia on the prognosis of patients undergoing superficial non-complex scar repair surgery. Methods From June 2023 to April 2025, 78 patients undergoing superficial non-complex scar repair surgery in Ningdong Hospital of Ningxia Hui Autonomous Region were divided into a control group and an observation group by the envelope method, with 39 cases in each group. The control group was given local anesthesia with midazolam, while the observation group was given local anesthesia with ropivacaine. The hemodynamics, stress response, dosage of anesthesia, number of additional injections, visual analogue scale (VAS) of pain and safety were compared between the two groups. Results The levels of MAP, HR, COR and ADR in the observation group at T1, T2 and T3 time points were better than those in the control group (P <0.05). The anesthetic dosage in the observation group was lower than that in the control group, the number of additional anesthetic administrations was less than that in the control group, and the VAS score at 48 hours after operation was lower than that in the control group (P <0.05). There was no significant difference in the incidence of complications between the observation group and the control group (P >0.05). Conclusion Ropivacaine local anesthesia can stabilize perioperative hemodynamics indexes in patients undergoing superficial non-complex scar repair surgery. It can improve stress response, reduce anesthetic dosage and the number of additional administrations, relieve pain, and has high drug safety.