Ｏｂｊｅｃｔｉｖｅ　To investigate the security and efficacy of dexmedetomidine combined with compound lidocaine cream in functional endoscopic sinus surgery(FESS).　Methods　Ninety patients were randomly divided into 3 groups(n=30): control group(N), dexmedetomidine group(D) and dexmedetomidine+compound lidocaine cream group(DL). Patients were subject to dexmedetomidine 0.6 μg/kg iv, followed by dexmedetomidine 0.6 μg·kg-1·h-1 in group D and DL and volumetric 0.9% NaCl in group N 15 min from induction to end of operation. Thereafter，the cream of compound lidocaine in group DL and that of no compound lidocaine in group D and N was administered intranasal 15 min before operation. MAP was retained at about 70 mmHg(1 mmHg=0.133 kPa) by remifentanil and propofol. HR and MAP were recorded 15 min before induction(T0), 15 min(T1), 30 min(T2) and 45 min(T3) after operation and instantly after extubation(T4). The duration of operation and PACU, extubation time, amount of bleeding and dosage were recorded. Quality of the surgical field, modified assessment of alertness/sedation(MOAA/S) score and VAS were assessed in PACU.　Results　There was no significant difference in age, weight, sex ratio and duration of operation between the three groups(P>0.05). Compared with group N, doses of propofol and remifentanil and amount of bleeding in group D and DL were decreased(P<0.05) and had no significant difference between group D and DL(P>0.05). MAP and HR had no difference from T0 to T4 between group D and DL(P>0.05). Compared with group D， MAP had no significant difference from T0 to T3 (P>0.05) and increase at T3 in group N while HR increase from T0 to T4 (P<0.05). MAP or HR in group DL and D were lower at T4 (P<0.05) and in group N higher than at T0 (P<0.05). Residence time in PACU was decreased in group N [(35±6) min]（P<0.05） and had no difference in group DL[(50±10) min] compared with group D[(49±9) min](P>0.05). SSFQ in group D and DL were better than that in group N (P<0.05) and had no difference between group D and group DL(P>0.05). MOAA/S score was increased in group N(4.5±0.5)（P<0.05） and had no difference in group DL (2.9±0.5) compared with group D (3.0±0.3)(P>0.05), while VAS was increased in group N (2.8±0.5)（P<0.05） and decreased in group DL(0.9±0.5) (P<0.05) compared with group D (1.8±0.6).　Conclusions　Application of dexmedetomidine combined with compound lidocaine cream is feasible and safe during FESS. It shows good quality of the surgical field, reduced extubation reaction and good postoperative comfort.