Abstract: AIM To observe the effects of dexmedetomidine on emergence from general anesthesia in patients with essential hypertension. METHODS Sixty patients with essential hypertension undergoing cervical vertebral surgery were randomly divided into group D and group C (30 cases each), respectively, receiving 0.5 μg/kg dexmedetomidine and 1 μg/kg fentanyl at 10 min before the completion of surgery. Heart rate (HR), systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) were recorded before anesthesia (T0), 10 min before the completion of surgery (T1), after the completion of surgery (T2), 1 min before extubation (T3), and 5 and 10 min after tracheal extubation (T4, T5). VAS pain score was evaluated and Ramsay sedation score was recorded at T5. Incidences of cough, agitation and shivering were also recorded during emergence. RESULTS In group D, HR at T2 was lower than that at T1 (P<0.05). HR and SBP in group C at T3 and T4 were higher than those in group C at T0 (P<0.01, P<0.05). HR, SBP and DBP in group D were lower than those in group C at T3, T4 and T5 (P<0.05, P<0.01). No statistical difference was observed in VAS pain score between groups. Ramsay score in group D was higher than in group C. Incidences of agitation and cough in group D were lower than those in group C during the emergence period (P<0.05). CONCLUSION Dexmedetomidine (0.5 μg/kg) given to patients with essential hypertension before the completion of surgery could reduce hemodynamic fluctuation, decrease the risk of adverse reaction and provide more safety during the emergence period.