Abstract： Objective:To explore the effects of dexmedetomidine on inflammatory and stress responses in elderly pa tients with femoral neck fractures after surgery.Methods:A total of 86 elderly patients with femoral neck fractures from June 2021 to June 2023 were selected from our hospital and divided into an observation group(n=43)and a control group(n=43)using the random table method.The control group was injected with 0.5 μg/kg sodium chloride injection by an intravenous in fusion pump for 15 min before anesthesia induction.The observation group was injected with 0.5 μg/kg dexmedetomidine using an intravenous infusion pump for 15 min before anesthesia induction.The dosage of propofol,operation time,intraopera-tive blood loss,eye opening time and extubation time,pain at 1,12,and 48 h after surgery,inflammatory response,and stress response before and 24 h after surgery were compared between the two groups.Results:The propofol dosage in the observation group was lower than that in the control group(P＜0.05),but there was no significant difference in the operation time and blood loss between the two groups(P＞0.05).Eye opening and extubation times in the observation group were shorter than those in the control group(P＜0.05).The VAS scores of the observation group at 1,12,and 48 h were lower than those of the control group(P＜0.05).There was no significant difference in the serum IL-6 and CRP levels between the two groups before surgery(P＞0.05).The levels of serum IL-6 and CRP 24 h after surgery were higher than those before surgery(P＜0.05),and the levels in the observation group were lower than those in the control group(P＜0.05).There was no signif-icant difference in the preoperative serum Cor and NE levels between the two groups(P＞0.05).The levels of serum Cor and NE 24 h after surgery were higher than those before surgery(P＜0.05).The levels in the observation group were lower than those in the control group(P＜0.05).Conclusion:Dexmedetomidine has a good analgesic effect on elderly patients after femoral neck fracture,can accelerate the recovery of patients,and has little effect on the inflammatory and stress responses.