To investigate the influence of dexmedetomidine nasal inhalation during laparoscopic total hysterectomy of patients on the hemodynamic and stress level of the patients. Methods: 149 patients who wanted total laparoscopic hysterectomy were selected and were randomly divided into three groups according to the envelope random method. And the patients in the three groupds were given the drugs of anesthetic induction and anesthetic maintenance. Before operation, 35 patients in group A were given dexmedetomidine nasal inhalation, 58 patients in group B were given dexmedetomidine intravenous infusion, and 56 patients in group C were given saline intravenous infusion. The Ramsay sedation score at 5min after extubation, the Riker sedation agitation score, the values of postoperative heart rate (HR), mean arterial pressure (MAP), and systolic blood pressure (SBP), the stress levels at home entry (T0), 1min after endotracheal intubation (T1), and 3min after endotracheal intubation (T3), and the situations of postoperative recovery and adverse reactions of the patients were compared among the three groups. Results: The scores of Ramsay sedation and the Riker sedation and agitation of the patients in group A in 5 minutes after venous extubation were significantly lower than those of the patients in group C (P<0.05). The values of HR, MAP, and SBP of the patients in three groups at extubation and in 3 minutes after extubation were significantly higher than those of the patients at eye opening. The values of HR and SBP of the patients at extubation and at 3 minutes after extubation had no significant difference between group A and group B, but which of the patients in group A and group B were significantly lower than those of the patients in group C. The values of HR and SBP of the patients in group A and group B at extubation, at 3min after extubation, and at eye opening were significantly lower than those of the patients in group C (P<0.05). The values of HR, MAP, and SBP of the patients in the three groups at extubation and at 3min after extubation were significantly higher than those of the patients at eye opening (P<0.05). The Cor level of the patients at T1 and T2 in group A and in group B was significantly higher than that at T0. The Cor level of the patients had no significant difference between group A and group B, but which of the patients in group A and in group B was significantly lower than that of the patients in group C. The Glu level of the patients in the three groups at T1 and at T2 was significantly higher than that at T0. The Glu levels of the patients had no significant difference between group A and group B, but which of the patients in group A and group B was significantly lower than that of the patients in group C (P<0.05). The recovery time, the extubation time, and the respiratory recovery time of the patients in group A and in group B were significantly shorter than those of the patients in group C. The incidences of nausea, vomiting, bradycardia, and hypotension of the patients in group A and in group B were significantly lower than those of the patients in group C, and which of the patients in group A was significantly lower than that of the patients in group B (all P<0.05). Conclusion: The sedative effect, the hemodynamic, the stress level, and the postoperative recovery of dexmedetomidine nasal inhalation during laparoscopic total hysterectomy of the patients are similar to those of dexmedetomidine intravenous pump infusion, but the dexmedetomidine nasal inhalation is more convenient, with less postoperative adverse effect.