Ｏｂｊｅｃｔｉｖｅ　To investigate the change of sevoflurane pharmacodynamics during cholecystectomy in elderly patients with hepatopulmonary syndrome(HPS).　Methods　Forty eight cases of patients undergoing elective cholecystectomy, male or female, aged 60 to 74 years old, Child-Pugh class A or B grade, ASA grade Ⅱ or Ⅲ, with normal function of lung and renal, were chosen for this study. These patients were divided into hepatopulmonary syndrome group (group HPS, n=18) and normal group (group C, n=30) according to the result of contrast-enhanced echocardiography and arterial blood gas analysis. All patients were established venous channels and sedated with dexmedetomidine after entering the operation room. Anesthesia was induced with propofol 2 mg/kg, sufentanil 2 μg/kg and vecuronium 0.1 mg/kg. After intubation, concentration of sevoflurane is maintained at a preset level to maintain anesthesia. MAC value was measured by upper and lower cross-point assay. During operation, BIS value was maintained within 40-50, blood pressure and heart rate were maintained stable. Duration of anesthesia was record. We observed the difference of sevoflurane MAC values between two groups, time of opening eyes after surgery, as well as time of BIS values recovered to 85.　Results　MAC of group HPS(0.88±0.07)%, while the MAC of group C(1.13±0.9)%, the two groups were significantly different(P<0.05). Compared with group C, patients in group HPS demonstrated increased time to open eyes after withdrawl ［(28±9) min vs (16±6) min］, BIS values recovered to 85 ［(34±9) min vs (21±7) min］ and extubation ［(38±5) min vs (26±3) min］(P<0.05).　Conclusions　The requirement of sevoflurane decrease in elderly patients with HPS during cholecystectomy and recovery time delay significantly.