Abstract: Objective：To explore the effect of intravenous lidocaine combined with dexmedetomidine on cardiovascular response during tracheal extubation in patients undergoing thyroid surgery under general anesthesia. Methods： 120 patients undergoing thyroid surgery under tracheal intubation general anesthesia in our hospital from January 2017 to December 2017 were randomly divided into four groups. Group A (control group) was given intravenous drip of 100 mL saline before anesthesia induction more than 10 min，intravenous injection of 2 mL saline 2 minutes before extubation. Group B (dexmedetomidine group), dexmedetomidine was diluted to 100 mL saline at a dose of 1 μg·kg-1 for more than 10 min by intravenous drip before anesthesia induction, and intravenous injection of 2 mL saline 2 min before extubation. Group C (lidocaine group), intravenous drip of 100 mL saline more than 10 min before induction, and intravenous injection of 1 mg·kg-1 lidocaine 2 min before extubation. Group D (lidocaine combined with dexmedetomidine group), dexmedetomidine was diluted to 100 mL saline at a dose of 1 μg·kg-1 for more than 10 min by intravenous drip before induction，and intravenous injection of 1 mg·kg-1 lidocaine 2 min before extubation. Heart rate, blood pressure and cough were observed at the time of entering the operating room, at the end of the operation, at the time of extubation and 5 min after extubation. Results： Compared with the control group (group A)， the incidence of chocking cough and the change of heart rate and blood pressure in group B， C and D decreased， and the incidence of chocking cough and hemodynamic changes decreased more in group D. Conclusion：Intravenous lidocaine combined with dexmedetomidine can effectively inhibit extubation chocking cough response and maintain hemodynamic stability in patients undergoing thyroid surgery under tracheal intubation general anesthesia.