Objective To study the clinical efficacy and safety of fine anesthetic management in general anesthesia for pelvic tumor patients who undergoing open surgery. Methods A total of 96 elective patients with pelvic tumors who need general anesthesia were selected. ASA Ⅰ-Ⅱ level was randomly divided into two groups: the experience group (group B, the control group) and the refined anesthesia management group (group B, the observation group), with 48 cases in each group. Patients in group B accept anesthesia management based on clinical experience of anesthesiologists, patients in group B accept anesthesia management based on index of instruments and equipment (including the guidance of anesthesia depth monitoring and closed-loop muscle relaxant injection system, heart function monitor). Time points setting as follows: 3 min after the Narcotrend (NT) numerical data in the room (T0), immediately after intubation (T1), into the abdomen (T2), resected immediately (T3), closing abdomen (T4), skin suture (T5), tracheal extubation (T6), consciousness recovery (T7), out of room (T8). MAP, HR and RR were recorded. Also, index as follows was recorded: SpO2, Narcotrend stage (NTS), Narcotrend index(NTI), myocutaneous count, train-of-four(TOF), stroke volume variation (SVV), anesthetic dosage, fluid volume, urine volume, intubation (according to the Copper score method), recovery time (stopping to call every time), extubation time (between withdrawal and extubation time), sedation score at leaving operation room, the adverse reactions, the time of stay in the ICU and the time from operation to discharge. Results Compared with group A, MAP and HR in group B were low at T1-T8 time (P<0.05). NTS was high in phase D1-E2 (P<0.05). In group B, the dosage of midazolam (P<0.05), propofol, sufentanil, remifentanil and atracurium sulfonate were small (P<0.05). Compared with group A, the total amount of group B was low (P<0.05). The time of awakening, the time of extubation was short. The Copper score was high. The Ramsay score was low (P<0.05). The adverse reactions and complications in group B were less than numbers in group A. The stay time in the guardianship and the time of discharge of patients in group B were shorter than the time in patients of group A (P<0.05). Conclusions The fine anesthesia management makes smooth induction and maintenance, timely and complete awakening, fewer adverse reactions and complications, better postoperative outcome. Thus, fine anesthesia is safe and feasible. Key words: Anesthesia; Pelvic neoplasms