Maxillofacial cosmetic surgery involves complex anatomical structures, abundant blood supply and proximity to important organs in the head and face region, resulting in high surgical difffculty. It has strict requirements for the sedative and analgesic effect and safety of clinical anesthesia management, and the anesthesia plan needs to balance efficient analgesia and low systemic side effects. Dexmedetomidine has the advantages of little impact on the cardiovascular system and no respiratory depression, which is suitable for the anesthesia needs of maxillofacial cosmetic surgery. Therefore, a new anesthesia administration scheme of dexmedetomidine pre-nasal spray combined with pump infusion has been derived clinically. Preoperative nasal spray can achieve preemptive analgesia, effectively inhibit the transmission of perioperative pain signals and reduce pain intensity. Intraoperative pump infusion can maintain stable blood drug concentration and achieve long-term sedative and analgesic effects. Based on this, this paper summarizes the pharmacological characteristics of dexmedetomidine and the anesthesia characteristics of maxillofacial cosmetic surgery, and systematically summarizes the clinical application methods, anesthesia effects and core mechanisms of dexmedetomidine pre-nasal spray combined with pump infusion, in order to provide reference for the standardized application of this scheme in maxillofacial cosmetic surgery.