Objective To observe the effect of intravenous dexmedetomidine combined with ropivacaine after operative incision in pediatric laparoscopic surgery.Methods One hundred and twenty children undergoing laparoscopic surgery, aged 3 to 7 years old, ASA physical status Ⅰ, Ⅱ, were divided into 3 groups (n =40) by random number table method. Group A was the control group, 1.0 μg/kg fentanyl was given before pneumoperitoneum was closed. Group B received 0.25% ropivacaine infiltration incision after operation. Children in group C were received 0.4 μg/kg dexmedetomidine intravenously before anesthesia induction, and 0.25% ropivacaine was used to infiltrate the incision after surgery. The dosage of anesthetic drugs, incidence of emergence agitation, PACU duration, and NRS scores at 4 h, 8 h, 12 h, 24 h, and 48 hours after surgery were recorded, respectively. The incidence of perioperative complications, hospital stay, and parental satisfaction were recorded.Results Compared with group A and B, the incidence of emergence agitation in group C was significantly reduced and parental satisfaction was greatly improved (P < 0.05). Compared with group A, NRS scores at 4 h, 8 h, 12 h after operation were significantly reduced in group B and C (P < 0.05), but there was no difference in the incidence of perioperative complications, PACU stay time, and hospital stay among the three groups (P > 0.05).Conclusion Intravenous dexmedetomidine combined with postoperative incision infiltration with ropivacaine can reduce the incidence of emergence agitation in pediatric laparoscopic surgery, reduce postoperative pain, and improve parental satisfaction.