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OBJECTIVE: To compared the treatment effects of dexmedetomidine and remifentanil on delirium after hip fracture surgery in elderly patients. METHODS: 120 cases of elderly patients with hip fracture surgery and admitted into Ganzhou Municipal Hospital fron Jun.2014 to May 2015 were selected to be divided into group A and group B via the random number table,with 60 cases in each group. Group A were treated with intravenous 0.3-0.8 μg/( kg· h) dexmedetomidine, while group B received intravenous 1 000-2 500 μg/h remifentanil, the disturbance of consciousness assessment evaluation method was adopted to determine the incidence of delirium in two groups of patients. RESULTS: The incidence of delirium in group A was 13.33% (8/60), and in group B was 31.67% (19/60), the difference was statistically significant (P<0.05). The postoperative adverse reactions were mainly be seen in sinus bradycardia (SB), hypotension and the endotracheal intubation caused by dyspnea. The incidence of SB, hypotension and the endotracheal intubation caused by dyspnea in group A were respectively 23.33% (14/60), 25.00% (15/60) and 3.33% (2/60), and in group B were respectively 30.00% (18/60), 40.00% (24/60) and 20.00% (12/60), with statistical significance (P<0.05). CONCLUSIONS: Dexmedetomidine and remifentanil in treatment of delirium after hip fracture surgery in elderly patients can reduce the incidence of delirium, the incidence of SB, hypotension and the endotracheal intubation caused by dyspnea and some other adverse reactions, it is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]