BACKGROUND: The present study was designed to examine the effect of a combination of nicardipine and low dose alfentanil on hemodynamic response following endotracheal intubation. METHODS: Thirty patients (20-65 yr) were assigned randomly to receive nicardipine (N: 20microgram/kg) or a combination of nicardipine and low dose of alfentanil (NA: nicardipine 10microgram/kg and alfentanil 5microgram/kg). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured at 1, 2 min after anesthetic induction, and every minute for 5 min after intubation. RESULTS: The magnitude of increases in SBP and DBP were non-significantly smaller in the NA group than in the N group, and increase in HR were significantly lower in the NA group. CONCLUSIONS: These results indicate that the nicardipine with alfentanil combination was more effective than nicardipine alone at attenuating blood pressure and heart rate increases following intubation.