Objective To investigate the trend of hemodynamic changes in patients with intracranial aneurysms undergoing interventional surgery during operation and recovery period and the effect of pharmacological interventions.Methods A total of 86 patients with intracranial aneurysms undergoing interventional surgery in our hospital from November 2017 to June 2019 were randomly divided into study group (n = 43) and control group (n = 43). The control group was treated with remifentanil and sevoflurane, while the study group was treated with dexmedetomidine on the basis of the control group. The perioperative [before the induction of anesthesia (T₀), after tracheal intubation (T₁), 15 minutes after the induction of anesthesia (T₂), and after operation (T₃)] hemodynamic indexes, cerebral oxygen metabolism, extubation time, the time to eye opening, the time to the recovery of spontaneous breathing, and adverse reactions of the two groups were recorded.Results There were differences in heart rate (HR), mean arterial pressure (MAP), cerebral extraction ratio for oxygen (CERO₂), and arterio-jugular difference of oxygen content (Da-jvO₂) between the two groups (P < 0.05). The extubation time was longer in the control group relative to the research group (P < 0.05), but the time to eye opening and the time to the recovery of spontaneous breathing were not different between the study group and the control group (P > 0.05). The incidence of adverse reactions in the study group (13.95%) was lower than that in the control group (32.56%) (P < 0.05).Conclusions Abnormal hemodynamic fluctuations in patients with intracranial aneurysms during operation and recovery period can be ameliorated by dexmedetomidine combined with sevoflurane, which can improve cerebral oxygen metabolism and shorten the extubation time after operation with a low incidence of adverse reactions.