Objective To investigate the effect of lidocaine cream on hemodynamics and stress response during periextubation in patients with tracheal intubation under general anesthesia，and to provide reference for clinical safe drug use. Methods?80 patients receiving elective surgery under general anesthesia (operation time less than 3 h) in Yue Bei People’s Hospital from January to August 2021 were selected as the research objects. The patients were divided into control group, taking group, smearing group and taking and smearing group by random number table, with 20 cases in each group. The control group did not receive lidocaine intervention, the taking group took 3 mL of lidocaine cream under the throat for 3 minutes,3 mL of lidocaine cream was applied to the tracheal tube cuff and evenly applied 3 times in the smearing group.3 mL of lidocaine cream was applied to the throat for 3 minutes, and 3 mL of lidocaine cream was applied to the tracheal tube cuff in the taking and smearing group. The heart rate (HR) and average arterial pressure (MAP) in the 10 min after entering the room (T0), 1 min before endotracheal intubation (T1), immediately after endotracheal intubation (T2), 5 min after endotracheal intubation (T3), before sputum aspiration (T4), after sputum aspiration (T5), before balloon release (T6), after balloon release (T7), 5 min after extubation (T8) were calculated of the four groups. The adverse event rates were recorded. Results?The changes of?HR in smearing group at T4, T5, T6 and T7 time points were lower than those in control group (P ＜ 0.05). The changes of HR at T2, T3, T4, T5, T6, T7 and T8 time points were lower in the taking and smearing group than in the control group (P ＜ 0.05). The incidence of choking during balloon release was significantly lower in the smearing group and taking and smearing group than in the control group (P ＜0.05). There was no significant difference in the incidence of sore throat among the 4 groups（P ＞ 0.05）. Conclusion?Lidocaine cream can effectively inhibit the hemodynamic changes caused by tracheal intubation in general anesthesia operation within 3 hours, reduce the incidence of breath-holding, agitation and choking during peri-extubation.