Objective To explore the effects of target controlled infusion of propofol combined with Total intravenous anesthesia on perioperative hemodynamics, quality of recovery and delirium in pediatric hernia repair. Methods From January 2020 to June 2023, 142 children with laparoscopic hernia repair in our hospital were selected as research objects. Random number table method was divided into control group and observation group with 71 cases. The control group was given total intravenous anesthesia, while the observation group was given total intravenous anesthesia with propofol. The effective time of anesthesia, the dose of propofol, the dose of remifentanil, the operation time and the anesthetic effect of the two groups were compared, the Mean arterial pressure (MAP), Heart rate (MAP) and Pulse oxygen saturation (SpO2) of the two groups were observed before anesthesia (T0), immediately after intubation (T1), when cutaneous resection (T2) and after surgery (T3), the quality of recovery was analyzed, and the incidence of adverse reactions was analyzed. Results The excellent and good rate of anesthesia in the observation group was 97.18%, higher than 85.92% in the control group (P<0.05). At T1, MAP, HR and SpO2 in 2 groups were lower than those at T0 (P<0.05). At T2, MAP, HR and SpO2 in control group were lower than those at T0 (P<0.05). At T1 ~ T2, MAP, HR and SpO2 in observation group were higher than those in control group (P<0.05). Ramsay sedation score immediately after extubation in observation group was higher than that in control group (P<0.05), recovery time of spontaneous breathing, mandatory eye opening time, extubation time and stay time in anesthesia recovery room were shorter than those in control group (P<0.05). The incidence of delirium in observation group was lower than that in control group (P<0.05). Conclusions Compared with intravenous and intravenous anesthesia, intravenous propofol combined with Total anesthesia can improve sedation effect, reduce hemodynamic fluctuations, improve recovery quality, and reduce the incidence of delirium.