Abstract: In patients with controlled hypertension, received chemotherapy underwent mastectomy operation for breast cancer; fentanyl 1mic/kg i.v. given at the time of closure of anesthesia is a simple, effective, and practical method in blunting cardiovascular responses to tracheal extubation and emergence from anesthesia. Further studies are required in patients with CAD and cerebrovascular disease in order to evaluate the advantage, beneficial effects, and safety of fentanyl compared with these factors in other drugs used to attenuate the hemodynamic changes caused by extubation. This does not lead to respiratory depression or prolonged recovery. The use of 2 mic/kg fentanyl at the same time provide much more control of the heart rate than 1mic/kg which may be beneficial for the patients with coronary artery disease (CAD) but with some delay in the extubation time in comparison to 1mic/kg of fentanyl.