Electromyographic neuromonitoring (EMG-NM) is a widespread approach in thyroid and parathyroid surgery. Intact laryngotracheal reflexes without neuromuscular block present a clinical problem. A prospective study involved 56 patients who underwent EMG-NM-assisted elective thyroid and parathyroid surgery under general anesthesia. Patients were randomized into 2 groups. In one group, we used special anti-reflexive endotracheal tubes and injected lidocaine into the area between the cuff and tracheal mucosa. We analyzed the possibility of EMG-NM, need for opioids and clinical manifestations of laryngotracheal reflexes. Lidocaine injection did not significantly affect myographic parameters of recurrent laryngeal nerve (1.81±0.82 vs 2.05±0.63, p=0.25). Differences in laryngotracheal reflexes (2 vs 5, p=0.42) and total fentanyl consumption were not significant. The final role of lidocaine in EMG-NM-assisted thyroid and parathyroid surgery requires further researches.