The aim of this study was to compare the effects of remifentanil and fentanyl given in combination with a target-controlled infusion (TCI) of propofol on haemodynamic reaction and recovery. We included 60 patients (18 - 70 years, ASA I - II) who were scheduled for elective gynaecological laparoscopy. After premedication with midazolam (7.5 mg per os), anaesthesia was induced by TCI propofol (target concentration: 6 μg/ml initially and 3 μg/ml after 15 min.), cisatracurium (0.1 mg/kg) and either remifentanil (0.25 μg/kg/ml initially and 0.15 μg/kg/ml after 10 min.; further administration according to the actual need) or fentanyl (0.1 mg initially plus additional 0.05 mg where required). The two groups were compared regarding perioperative haemodynamics, times of recovery, postoperative vigilance, cognitive function (Mini-Mental-Status-Test), reaction time (Wiener Determinationstest), pain intensity and postoperative nausea/vomiting (PONV). Both opioids provided adequate haemodynamic stability during surgery. Patients of the remifentanil group showed a lower arterial blood pressure after the induction of anaesthesia. There were no differences between the groups in terms of recovery times, vigilance, cognitive function, reaction times, pain intensity and PONV. The use of remifentanil cannot guarantee shorter recovery and fast restoration of cognitive performance after outpatient surgical procedures, however. Recovery from anaesthesia also depends on the premedication, anaesthetics and postoperative analgesics used, which can mask the expected advantageous effects of remifentanil.