Objective To investigate the effects of remifentanil in painless bronchoscopic examination of elderly panents.Methods One hundred and twenty elderly patients undergoing painless bronchoscopic examination were randomly divided into 4 groups (n=30),the group A was administered with propofol and the groups B,C and D were administered with propofol and remifentanil(remifentanil dose:0.05 μg · kg-1 · min-1 in the group B,0.10μg · kg-1 · min-1 in the group C and 0.15 μg · kg-1 · min-1 in the group D).The body moving response,hemodynamic changes,propofol dose,examination time,wake-up time,departure time and adverse reactions in each group were observed during the examination process.Results During the examination process,the body moving response and bucking of the group A were significantly higher than those of the other three groups(P＜0.05);in hemodynamics,the group A fluctuated greatly,while the group B,C and D were relatively stable,but the incidence rate of hypotension,bradycardia and transient respiratory depressionof the group D were higher than those of the other three groups(P＜0.05);propofol dose of the group A was significantly higher than that of the other three groups (P＜0.05)and the group B was higher than the group C and D(P＜0.05).In wake-up time and departure time,the groups B,C,D were significantly better than the group A(P＜0.05),while the group C and D were better than the group B(P＜0.05).Conclusion Remifentanil can be used in painless bronchoscopic examination for elderly patients,and the effect is better by using propofol combined with remifentanil at a dose of 0.1 μg · kg-1 · min-1.