Objective: To evaluate the effectiveness and safety of electroacupuncture in conjunction with additional medications in providing analgesia and stabilizing hemodynamic parameters during total thyroidectomy. Methods: This randomized controlled trial included 100 patients who underwent a total thyroidectomy between October 2022 and October 2023 at the Vietnam National Hospital of Acupuncture. The patients were randomized into two groups. The electroacupuncture analgesia (EA) group received EA stimulation at five acupuncture points: Hegu (LI 4), Neiguan (PC 6), Shuitu (ST 10), Quepen (ST 12), and Yifeng (SJ 17), while the control group received a bilateral superficial cervical plexus block. Primary outcomes included the level of analgesia and perioperative vital signs in both groups. Additionally, pain thresholds and serum β-endorphin levels were measured before and after electroacupuncture in the EA group. Results: Complete analgesia (Level A) was attained in 86% and 76% of the patients in the EA and control groups, respectively, with no significant difference between the two groups (P = 1.00). In the EA group, the mean pain threshold after receiving EA doubled (648.7 (77.4) g/s vs. 305.3 (45.3) g/s, P < .001), and the mean serum β-endorphin level increased by approximately 13.5 pg/mL (P < .001). All patients remained hemodynamically stable throughout the surgery. Conclusion EA, in conjunction with additional medications that stimulate five acupuncture points, LI 4, PC 6, ST 10, ST 12, and SJ 17, was well tolerated and effectively maintained a suitable level of analgesia and hemodynamic stability during total thyroidectomy.