The aim of this study is to compare the effect of midazolam and dexmedetomidine on hemodynamic response control after laryngoscopy and intubation during upper extremity surgery. The study is carried out as a one-center double blind randomized clinical trial on 80 patients in ASA class І and II, being at the age of 18 to 60 years old and candidate for upper extremity elective surgery in Rajai hospital, Qazvin. Patients who are drug abusers or have cardiac and pulmonary diseases and hypertension will be excluded. Randomization will be done through block randomization method. For intervention group, 2 µg/kg fentanyl and 0.6 mg/kg dexmedetomidine and for control group 2 µg/kg fentanyl and 0.05 mg/kg midazolam will be injected as a prodrug. After two minutes, anesthesia induction will be performed using 2 mg/kg propofol and 0.2 mg/kg Atracurium. Three minutes after injection of atracurium, tracheal intubation will be performed through direct laryngoscopy. Systolic and diastolic blood pressure, mean arterial pressure, heart rate and arterial oxygen saturation will be measured at baseline, before of induction, 1, 5, 10, 20, 30, 60 and 90 minutes after intubation, at the end of surgery and at recovery.