Background: Endotracheal intubation and extubation are crucial procedures in surgical operations, and they are frequently linked with significant hemodynamic responses and cough reflexes, which can result in complications. The purpose of this study was to determine whether lidocaine/prilocaine cream (EMLA cream) was successful in regulating these responses. Methods: Three groups of patients were assigned to receive EMLA cream, lidocaine gel, or a placebo. Mean arterial pressure (MAP) and heart rate (HR) were the hemodynamic parameters that were recorded prior to induction, one minute after intubation, and during recovery. Additionally noted was the frequency of cough reflex during recovery. SPSS V. 27wasusedtoanalyzethedata,andbothdescriptiveandinferentialstatistics wereused.Results:Incomparisontotheplacebo group, the EMLA cream group had significantly lower MAP and HR levels during the intraoperative and postoperative periods. The EMLA group had a meanMAPof105.09±14.178mmHgduringinductionand97.17±13.796mmHgduring recovery, compared to 88.29 ± 15.356 mmHg and 98.34 ± 13.841 mmHg in the placebo group. The EMLA group had a mean heart rate of 96.23 ± 17.687 bpm during induction and 96.40 ± 16.518 bpm during recovery, compared to 85.20 ± 18.253 bpm and 88.40 ± 17.172 bpm in the placebo group. The EMLA group had a considerably lower incidence of cough reflex (8.6%) than the lidocaine gel (51.4%) and placebo groups (65.7%). Conclusion: EMLA cream efficiently regulates hemodynamic responses and inhibits the cough reflex during endotracheal intubation and extubation. These results indicate that EMLA cream can improve patient safety and comfort, making it an important complement to anesthetic regimens. Additional multicenter studies with larger sample sizes are necessary to corroborate these findings.