AbstractIntroduction: Rapid smooth induction, rapid recovery, perioperative hemodynamic stability, minimum post-operative pulmonary complications and effective analgesia intra-operatively and post-operatively are the main aspects of general anesthesia. Aim: To compare the attenuation of the pressor response to laryngoscopy and intubation with intravenous Fentanyl 2 mcg/kg and intravenous Butorphanol 40 mcg/kg. Materials and Methods: It is a randomized prospective comparative study comparing the two opioiddrugs. The patients were then randomly assigned into two groups of 30 each in Group F and Group B received Inj. Fentanyl 2 mcg/kg IV and Inj. Butorphanol 40 mcg/kg respectively. Results: There was no statistical significance between the Two groups (B / F) when the demographic parameters like age distribution (36.03 ± 7.73/36.23 ± 6.80), sex distribution (15/15 vs 16/14), weight (65.5 ± 7.72/66.63 ± 5.81) were compared. The comparison of parameters like pre operative pulse rate, systolic blood pressure, diastolic pressure, mean arterial pressure, rate pressure product, respiratory rate and sedation score was also found to be statistically insignificant between the two groups. Both the Butorphanol group and the Fentanyl group was comparable with respect to events of intra operative hypotension and intra operative Bradycardia. There was no significantly respiratory depression post extubation in both the groups. We observed that the post extubation sedation score was significantly higher with the Butorphanol group than with the Fentanyl group. A favourable side effect profile was observed with the Butorphanol group than with Fentanyl group with respect to the occurrence of post-operative shivering whilethe incidence of post-operative nausea and vomiting was similar between the groups. Conclusion: Intravenous Butorphanol prior to induction of anaesthesia helps in better attenuation of the hemodynamic response to laryngoscopy and intubation than intravenous Fentanyl. We conclude that Butorphanol could be an effective alternative to Fentanyl for attenuation of the hemodynamic stress response to laryngoscopy and intubation.