Background　Through many years of studies of primary trigeminal neuralgia, cerebellopontine angle area vascular compression cranial nerves of the brain stem areas can lead to the corresponding syndrome, the nerve vascular compression syndrome. Microvascular decompression(MVD) has become a safe and effective surgical method. During microvascular decompression of trigeminal neuralgia, bradycardia may occur, the brain beats may disturb the operation, and other adverse events may take place. The postoperative complications such as headache, nausea and vomiting, lower cranial pressure reaction may occur because of anesthetic mismanagement. 　Objective　In this paper, we provide some reasonable solutions to settle the above problems and avoid such complications.　Content　In this paper, we describe the operation position and method of trigeminal neuralgia MVD, discuss the basic requirement of anesthesia, including breathing and circulation management, the principle of neural electrophysiological monitoring and fluid infusion principle, the solution to avoid brain beats. Also we describes the anesthesia-related complications and its solutions.　Trend　MVD is widely applied to treat the primary trigeminal neuralgia. The existing anesthetic method is very good now, but still need to be improved, for the security of patients and avoiding the anesthetic complications.