Introduction: Hemodynamic stability is one of the main goals of any anesthesiologist. Aim 
of the work: The aim of this study is to evaluate the effect of two different adjuvants 
(fentanyl and magnesium sulphate) on hemodynamic response and arousal reactions as 
indicated by BIS values following laryngoscopy and endotracheal intubation, and to detect the 
related side effects. Patient and methods: After approval of the university ethical committee 
and obtaining informed consent from all patients, this prospective randomized double-blind 
controlled study was conducted in El-Minia university hospital during the period form may 
2017 to December 2017. A total of 60 adult female patients, between 20 and 60 years, 
American society of anesthesiologists grade I and II patient scheduled to undergo elective 
surgery under general anesthesia with endotracheal intubation were included in the study. 
Results: Demographic data of the three studied groups were comparable. Discussion:
Endotracheal tube remains the gold standard airway device for securing the airway during 
general anesthesia . however, laryngoscopy and intubation is associated with hemodynamic 
stress response manifested as tachycardia, hypertension and a variety of cardiac arrhythmias 
in addition to those hemodynamic changes, arousal reactions as indicated by increase the BIS 
values also occur with laryngoscopy and intubation. Summary and conclusion: This 
prospective randomized controlled study was conducted in El-Minia university hospital 
during the period from May 2017 to December 2017.