Purpose: To test the hypothesis that using remifentanil during nitrous oxide-sevoflurane anesthetic would be associated with less postoperative nausea and vomiting (PONV) compared to a similar technique with fentanyl. Scope: Sixty patients undergoing outpatient gynecologic laparoscopy were randomly assigned to remifentanil or fentanyl for intraoperative analgesia. The complete response rate (no PONV and no rescue) was 50% / 29 % in the remifentanil group and 37% / 12 % in the fentanyl group in the PACU and at 24 hours respectively (p=ns). Conclusion: The use of remifentanil was not associated with a reduction in the incidence of PONV, compared with fentanyl, in patients undergoing ambulatory gynecologic laparoscopy.