Objective To explore the effect of intranasal dexmedetomidine on the reversal of rocuronium‑induced residual neuromuscular blockade with sugammadex in children. Methods A total of 64 children, American Society of Anesthesiologists grade Ⅰ or Ⅱ, aged from 1 to 9 years, who were scheduled for lower abdominal surgery from April 2020 to November 2020, were selected. According to the random number table method, they were divided into two groups (n=32): an experimental group and a control group. Before surgery, they were intranasally administered with dexmedetomidine at 1.0 μg/kg or with an equal volume of normal saline, respectively. During surgery, train‑of‑four (TOF) stimulations were performed using a neuromuscular blockade monitor. After surgery, the patients were given sugammadex at 2.0 mg/kg in patients when TOF T2 appeared again during neuromuscular block monitoring. When TOF ratio (TOFR) was recovered to 0.9, their following data were recorded, including general information, time to operation, temperature after surgery, time to extubation and the length of post‑anesthesia care unit (PACU) stay. Meanwhile, the bispectral index (BIS) immediately before neuromuscular block, heart rate, as well as 2 min and 5 min after antagonism, heart rate, systolic blood pressure, diastolic blood pressure and the incidences of rash, nausea, vomiting and agitation during the recovery period were recorded. Results There was no statistical difference in general information, time to TOFR recovery to 0.9, time to operation and temperature after operation in the two groups (all P>0.05). The experimental group showed significantly extended time to extubation time and length of PACU stay (all P>0.05). Compared with the control group, the experimental group presented lower BIS immediately before antagonism and 2 min after sugammadex administration (all P<0.05), with reduction in the systolic blood pressure immediately before sugammadex administration (P>0.05); and there was no statistical significance in the indexes between the two groups at other time points (all P>0.05). There were no reports concerning rash, nausea and vomiting in the two groups during the recovery period. The incidence of agitation in the experimental group was significantly lower than that in the placebo group (P>0.05). Conclusion A single nasal dose (1 μg/kg) of dexmedetomidine before surgery does no extend the reversal of 2.0 mg/kg sugammadex for rocuronium‑induced residual neuromuscular blockade in children.