PURPOSE: The purpose of this study is to identify the changes of a physiologic nature and the sedative parameters associated with dexmedetomidine and pethidine, in patients undergoing plate and screw removal surgery, after orthognathic surgery. METHODS: Twenty-three patients were sedated with dexmedetomidine and pethidine during plate and screw removal, after orthognathic surgery. An initial loading dose of dexmedetomidine (1.0 microg/kg infused over 10 minutes) was followed by a maintenance dose (1.0 microg/kg/hr). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation, and heart rate were monitored. Perioperative amnesia and anxiety were recorded. RESULTS: Significant changes were found in the blood pressure and heart rate (Freidman test, P<0.05), but not in oxygen saturation (Freidman test, P>0.05). Amnesia during local injection was observed in eight patients (34.8%). Compared with the preoperative anxiety score, the intraoperative anxiety score was decreased. CONCLUSION: In this study, we found cardiovascular and respiratory stability in intravenous sedation using dexmedetomidine with pethidine, in plate and screw removal, after orthognathic surgery. Furthemore, intravenous sedation using dexmedetomidine with pethidine shows adequate analgesic and sedative effects.