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<p><strong>Objective </strong> To study the application of dexmedetomidine in patients undergoing temporal muscle sticking for moyamoya disease (MMD), and to discuss the possible mechanism of brain protection. <strong>Methods </strong> Sixty patients undergoing temporal muscle sticking operation were randomly divided into 2 groups: dexmedetomidine group (Group D, N = 30) and control group (Group S, N = 30), respectively receiving dexmedetomidine intravenous infusion (0.60 μ g/kg) and the same dose of normal saline before anesthesia induction. In Group D, dexemdetomidine was administered continuously (intravenous pumping) with the dose of 0.40 μg/(kg·h) perioperatively, while the same dose of normal saline was administered in Group S. Heart rate (HR) and mean arterial pressure (MAP) were recorded at T₀ (before administration), T₁(before tracheal intubation), T₂ (1 min after intubation), T₃ (at the moment of skin incision), T₄ (before extubation) and T₅(1 min after extubation) respectively. Total amount of propofol, remifentanil and patients' recovery conditions after anesthesia were also recorded. Glutamine and malondialdehyde (MDA) were measured and compared before and after operation. <strong>Results</strong> In group D, HR and MAP decreased significantly at T_2-4 compared with T₀ (<em>P</em> &lt; 0.05, for all). Total amount of propofol, remifentanil in Group D was lower than that in Group S (<em>P </em>&lt; 0.05, for all) and the patients' recovery conditions in Group D after anesthesia was better than Group S (<em>P </em>= 0.000, for all), without occurence of shivering, cough and dysphoria (<em>P</em> &lt; 0.05, for all). Glutamine and MDA increased after anesthesia compared with that before anesthesia in both 2 groups (<em>P</em> &lt; 0.05, for all), however, it was higher in Group S than that in Group D (<em>P</em> &lt; 0.05, for all). <strong>Conclusions</strong> Dexmedetomidine can provide stable hemodynamic condition during the anesthesia with patients undergoing temporal muscle sticking for moyamoya disease, and has a positive effect on improving both the outcome of the operation and recovery conditions. Also it can provide brain protection effect by decreasing the level of excitatory amino acids.</p><p> </p><p>doi: 10.3969/j.issn.1672-6731.2014.06.009</p>