Abstract: OBJECTIVE To compare the efficacy and safety of dexmedetomidine and etomidate in providing conscious sedation for awake craniotomy on cerebral functional area. METHODS Thirty patients(ASA Ⅰ-Ⅱ) scheduled for awake craniotomy on cerebral functional area were randomly divided into two groups: the dexmedetomidine group (group D, n=15) and the etomidate group (group E, n=15). After endotracheal intubation 2 min, in group D, dexmedetomidine 1 μg·kg^-1 was injected iv over 10 min, and then was infused at a rate of 0.5 μg·kg^-1·h^-1; in group E, etomidate was infused at a rate of 10 μg·kg^-1·min^-1. Scalp nerve block and local infiltration of incision and dura mater were performed in both groups. Before expecting awake 10 min, in group D, the rate of dexmedetomidine was decreased to 0.2 μg·kg^-1·h^-1; in group E, etomidate infusion was ceased. The time needed to arouse the patients, the quality of revival, the adverse events and MAP, HR, RE, SPO2, PETCO2 and OAA/S during revival, the degree of satisfaction of surgeons and patients to conscious sedation were observed. RESULTS The time needed to arouse the patients was not significant different in group D and group E(P>0.05). The quality of revival was significantly better in group D than in group E(P<0.05). The adverse events was significantly less in group D than in group E (P<0.05). The degree of satisfaction of both surgeons and patients to conscious sedation were higher in group D than in group E (P<0.05). CONCLUSION Compared with etomidate, in providing conscious sedation for awake craniotomy on cerebral functional area, dexmedetomidine can offer better quality of revival, less adverse events, higher degree of satisfaction of surgeons and patients to conscious sedation.