 Remifentanil is the first ultra-short acting opioid with a rapid onset. During the total intravenous anesthesia TIVA with propofol and remifentanil, prior administration of remifentanil could reduce the propofol infusion pain without other significant complications 6. However, remifentanil can decrease the arterial pressure and heart rate 7-8, so that it is likely to decrease the onset time of rocuronium for the opposite principle that ephedrine increases it. 