Purpose : A double blind, randomized study with two parallel groups, comparing systolic and diastolic pressure changing during intubation between 4% lidocaine and 0.9% normal saline 5 ml nebulized before induction of general anesthesia. Methods : Sixty patients, ASA class 1 or 2, age between 16-60 yrs scheduled for elective surgery under general anesthesia with endotracheal intubation. Patient with history of hypertension, ischemic heart disease or predicted difficult airway management were excluded from the study. Five minutes before induction of general anesthesia, they were breathing through face mask with nebulized with oxygen 10 L/min either with 5 ml of 4% lidocaine or 0.9% normal saline, midazolam 0.04 mg/kg, thiopental 5 mg/kg and succinylcholine 1.5 mg/kg were used for induction and intubation.Results : 4% lidocaine nebulized group failed to reduced hemodynamic changing during intubation period and 1, 2, 3, 5 and 10 minutes after intubation. Discussion : Without opioids premedication, only nebulized with 4% lidocaine 5 ml before intubation during induction of general anesthesia was not enough to blunt hemodynamic response to intubation.