ObjectiveTo assess the effectiveness and safety of target-controlled infusion (TCI) of remifentanil during remedial endoscopic retrograde cholangiopancreatography (ERCP) in the elderly patients.Methods390 patients (aged 65 years and over) undergoing ERCP were divided into two groups: remifentanil group (n =175) and lidocaine group (n =215). Remifentanil group were anaesthetized by TCI with remifentanil as method of sensible analgesia,while lidocaine group were anaesthetized by lidocaine as conventional local anesthesia.Arterial blood pressure,heart rate and oxygen saturation (SpO2) were monitored during ERCP.The memory and feeling of pain during operation and side effects after operation were followed up. ResultsThe statistical differences in changes of blood pressure,heart rate and SpO2 were not found between the two groups.There were 165 cases(94.3 ％) with satisfactory anaesthetization,10 cases (5.7 ％ ) with mild and endurable pain and 7 cases(6.7％) with side effects of circulation and respiration during operation,while these symptoms improved after symptomatic treatment in remifentanil group.In lidocaine group,there were 25 cases(8.6 ％ ) with side effects of circulation and respiration during operation,most of patients were obviously uncomfortable,2 cases (1.8％) were intolerant of operation. Conclusions Targetcontrolled infusion of remifentanil during ERCP in the elderly is safe,effective and worthy of clinical popularization.