Objective To study the application, safety and efficiency of tetracaine sprayed through thyrocricoid puncture before intubation in intensive care unit ( ICU) . Methods Forty-one patients ready to undergo intubation, admitted in ICU from November 2009 to February 2010, were recruited in the study. They were randomly divided into a tetracaine group and a control group. 2% tetracaine was sprayed through thyrocricoid puncture before intubation in the tetracaine group but not in the control group. The hemodynamic variables and SpO2 at baseline ( T0 ) , beginning of intubation ( T1 ) , 1 min after intubation ( T2 ) , and 5 min after intubation ( T3 ) were recorded. The dosage of propofol and vasoactive agents, the incidence of hypotension, the times of intubation, and complications were also recorded. Results The variance rate about heart rate ( HR) , mean arterial pressure ( MAP) and rate pressure production on time of T1 and T2 were significantly lower in the tetracaine group than those in the control group ( P lt; 0. 05) . There was no difference about the incidence of successful intubation and hypoxia ( P gt; 0. 05) . The dosage of propofol during induction and vasoactive agents after intubation in the tetracaine group were less than those in the control group ( P lt;0. 05) . The incidence of hypotension after intubation in the tetracaine group was 35% , which was lower than 61. 9% in the control group ( P lt;0. 05) . There was no any complications and adverse accidents in the tetracaine group. Conclusions It is safe and simple to spray tetracaine through thyrocricoid puncture before intubation in ICU, which can effectively stabilize the hemodynamics, and decrease the dosages of propofol and vasoactive agents.