Abstract: AIM:To investigate the clinical application of dexmedetomidine in hypertension patients undergoing ophthalmologic surgery with local anesthesia. METHODS: A total of 60 hypertensive patients undergoing elective ophthalmologic surgery were randomly divided into two groups (30 cases in each group): dexmedetomidine group (group D) and control group (group C). A loading dose of dexmedetomidine (05 μg/kg) was infused slowly for 10 min in group D by i.v. pump before surgery, and 02 μg/(kg·h) was then infused continuously until completion of the surgery. The same volume of saline was infused continuously until the end of surgery in group C. Surgery was carried out with local anesthesia in both groups. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate (HR), saturation of pulse oxygen (SpO2), respiratory rate (RR), score of sedation or analgesia and adverse reactions were recorded in both groups at the following time points: before anesthesia (T0), injection of anesthetics (T1), 30 min after initiation of surgery (T2), and at the end of surgery (T3). RESULTS: HR, SBP, DBP, RR and visual analogue score (VAS) in group D were significantly lower than those in group C at T1, T2 and T3 (P<001); however, Ramsay score in group D was significantly higher than in group C at T1, T2 and T3 (P<001). A significant difference in SpO2 was observed at no time points between groups. The use of urapidil was lower but the comfort score was higher in group D compared with group C. No significant difference in the incidence of nausea, vomiting, and respiratory inhibition was found between groups. CONCLUSION: Intravenous administration of lowdose dexmedetomidine could relieve pain in patients with hypertension undergoing ophthalmologic surgery with local anesthesia, reduce fluctuation of hemodynamics and achieve some sedative effects and a high level of comfort without respiratory inhibition. This method has value for clinical application.