Dexmedetomidine is a novel, highly selective α2 adrenoceptor agonist, whereas oxycodone serves as a μand k-amboceptor agonist. To analyze the effects of dexmedetomidine combined with oxycodone in locally anesthetized patients undergoing transforaminal endoscopic resection of nucleus pulposus. 112 patients were evenly randomized into oxycodone group (OG), dexmedetomidine group (DG), oxycodone-dexmedetomidine combination group (ODG), and control group (CG). No significant difference among the four groups in terms of baseline information, recovery time, or atropine was found (p > 0.05). The mean arterial pressures (MAPs) and heart rates (HRs) in ODG reduced from the injection point and were dramatically lower over those in CG, and visual analog scale (VAS) scores in ODG at 1, 2, and 6 h following surgery were lower over those in other groups (p < 0.05). The combination of dexmedetomidine with oxycodone in the local anesthesia during analgesia and sedation of patients undergoing transforaminal endoscopic resection of the nucleus pulposus manifested tangible effects. Specifically, such improved perioperative inflammatory responses and controlled cellular immunity without promoting the onset of adverse reactions.