Objective：To observe the cardiovascular reactions and complications in elderly patients during general anesthesia extuba－tion after applying dexmedetomidine（DEX） guided by Narcotrend. Methods：Totally 60 elderly patients were randomly divided into DEX group and control group. DEX group：0.5 μg/（kg·h） Dex infusion was given at 30 min before finishing the surgery and narcotrend index（NI） was maintained at 65-79 by adjusting the concentration of DEX postoperatively. Control group：0.125 ml/（kg·h） 0.9% normal saline was given at 30 min before finishing the surgery. Systolic blood pressure（SBP），diastolic blood pressure（DBP），heart rate（HR） and NI values before the induction（T1），at the end of operation（T2），at tracheal suction（T3），at extubation（T4），5 min after the extubation（T5），10 min after the extubation（T6） were recorded. The spontaneous respiration recovery time，dwell time in PACU and complications were also recorded. Results：There were statistical differences in SBP，DBP，HR，NI values in T3，T4，T5 between two groups（P<0.05）. In control group，there were statistical difference in SBP，DBP，HR between T3，T4 and T1（all P=0.000）. There was no difference in the spontaneous respiration recovery time and dwell time in PACU between two groups（P=0.786，P=0.351）. There were statistical differences in the incidence of agitation between two groups（P=0.024）. Conclusion：Giving 0.5 μg/（kg·h） DEX infu－sion at 30 min before finishing the surgery and maintaining narcotrend index（NI） at 65-79 by adjusting the concentration of DEX postoperatively can maintain the stability of circulation and reduce the agitation without extending the spontaneous respiration recov－ery time and dwell time in PACU during general anesthesia extubation.