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目的：探讨右美托咪定对病态肥胖患者腹腔镜行胃转流术后康复的影响。方法选取48例全麻腹腔镜行胃转流术的病态肥胖患者，随机分为右旋美托咪定组（DEX组）和生理盐水组（NS组）。所有患者采用常规静脉诱导，气管插管，七氟烷吸入维持全身麻醉。DEX组患者术前给予静脉输注右美托咪定0.5μg?kg-1?h-1负荷剂量（输注10 min），并给予维持剂量0.3μg?kg-1?h-1到手术结束。NS组泵入生理盐水。手术结束后所有患者转入ICU，使用芬太尼镇痛并维持疼痛评分在0～3分。DEX组继续泵入右美托咪定（0.3μg?kg-1?h-1）；NS组予同样的容量和速度以泵入生理盐水。记录患者的术后清醒和拔管时间，记录患者疼痛评分，记录患者恶心呕吐发生情况，以及患者谵妄和躁动发生情况。结果与NS组比，DEX组患者气管拔管时间有明显缩短[（175.64±19.42）min vs（237.87±27.29）min，P＜0.05]，术后2 h和术后6 h患者疼痛评分明显降低（1.9±0.6 vs 2.8±1.4，2.4±1.0 vs 3.1±1.5，P均＜0.05），24 h内恶心呕吐发生率低（20.83% vs 41.66%，P＜0.05），躁动发生率低（4.2% vs 33.2%，P＜0.05）。结论右美托咪定用于病理肥胖患者腹腔镜胃转流术的镇静是安全有效的，且具有良好的镇痛作用，缩短拔管时间，降低患者恶心和呕吐发生率，减少躁动发生。“,”Objective To observe the effects of dexmedetomidine on postoperative recovery of morbidly obese patients undergoing laparoscopic gastric bypass surgery.Methods 48 morbidly obese patients undergoing general anesthesia laparoscopic gastric bypass operation, were randomly divided into dexmedetomidine group (DEX group) and saline group (NS group). DEX group was given dexmedetomidine load (0.5μg?kg-1?h-1, 10 min injection pump), and 0.3μg?kg-1?h-1 dexmedetomidine until the end of operation. NS Group used saline the same way pumping capacity. All patients were treated with conventional intravenous induction, tracheal intubation, seven sevoflurane inhalation to maintain general anesthesia. After the operation, the patient was transferred to ICU, and all the patient was given fentanyl for maintaining an analgesic score of 0~3. The DEX group was given dexmedetomidine (0.3μg?kg-1?h-1), NS group was given saline the same way pumping capacity. Postoperative awake time, extubation time, pain score, the incidence rate of nausea, vomiting, and restlessness were recorded. Results Compared with NS group, extubation time was shortened ([175.64±19.42]min vs [237.97±27.29] min,P<0.05), pain score was decreased at 2 h and 6 h after operation (1.9±0.6 vs 2.8±1.4, 2.4±1.0 vs3.1±1.5,P<0.05) in DEX group. There is significant difference in the incidence rate of nausea, vomiting (20.83% vs 41.66%,P<0.05) and restlessness (4.2% vs 33.2%,P<0.05) between the two groups.Conclusion Dexmedetomidine are safe and effective for postoperative morbidly obese patients undergoing laparoscopic gastric bypass surgery. Dexmedetomidine can shorten extubation time, reduce pain, decrease the incidence rate of nausea, vomiting, and restlessness.