Abstract: OBJECTIVE To investigate cerebral oxygen metabolism effects of right dexmedetomidine combined with etomidate anesthesia for elderly patients. METHODS Fifty elderly patients by the cardiopulmonary bypass heart surgery based on the random number tab were equally divided into experimental group and control group, all cases were given the anesthesia, the experimental group were infused with dexmedetomidine pyridine before induction, and the control group were received saline for induction, both groups were selected etomidate sedation. RESULTS The cardiopulmonary bypass time, aortic clamping time and surgical time of experimental group were significantly less than the control group (P<0.05). The blood lactose of the experimental group were on the T3 and T4 time points were significantly lower than the control group (P<0.05). the CaO₂ and CvO₂ values in the two groups on the T3 and T4 time points were significantly lower than the T1 and T2 time points (P<0.05), between the values of the two groups compared had not statistically significant 15 min before induction (T1), after sternotomy (T2), after CPB started 30 min (T3), at the end of surgery (T4). After surgery, the incidences of cardiac tamponade, hypoxemia, pulmonary infection, wound infections and other complications compared between the two groups had no significant difference and were improved by the symptomatic treatment. CONCLUSION right dexmedetomidine combined with etomidate anesthesia for elderly patients with cardiopulmonary bypass surgery may facilitate the implementation and ease the cardiopulmonary bypass cerebral oxygen metabolism, thereby reduce blood lactate values and to protect the safety of surgery.