AbstractBackground: Opioids administered before caesarean section under general anaesthesia reduce maternal stress response related to intubation and surgery but may decrease the Apgar score after delivery and when opioids are used. Aim: effect of low dose of shortacting opioid alfentanil on haemodynamic changes due to tracheal intubation during general anaesthesia for caesarean sections. Materials and Methods: Patients were taken for a period of 2 years in 60 pregnant patients between the ages of 18 and 40 years, scheduled for elective caesarean section, were assigned to two equal groups. GroupA:(N=30) Received alfentanil 10 mg/kg, diluted in normal saline (total volume of 10 ml), GroupP:(N=30) Received 10 ml normal saline as placebo for premedication. Results: There were no significant statistical differences among the two groups regarding age, weight, BIS and maternal preoperative haemodynamic parameters. Following alfentanil administration, systolic blood pressure decreased at 1, 5 and 10 min after endotracheal intubation. Diastolic blood pressure decreased only 1 min after intubation and heart rate decreased 1 and 5 min after intubation. There were significant statistical differences between the two groups in regard to mean heart rate 1 min after induction of anaesthesia (P = 0.01), 1 min after endotracheal intubation (P = 0.000) and 5 min after endotracheal intubation (P = 0.04). Mean BIS values were not significantly different between the two groups (P = 0.3). Mean of neonatal Apgar scores at 1 and 5 min and neonatal SpO2 were not significantly differerent between the two groups . Conclusion: Alfentanil as premedication decreased maternal systolic, diastolic blood pressure and heart rate in the 1st min of general anaesthesia for caesarean sections.