In this study, 33 patients were randomly assigned to receive desflurane (D) or isoflurane (I) for acoustic neuroma surgery. The time from end of the procedure to spontaneous breathing, extubation, eye-opening, hand-squeezing to command, and ability to state name, birthdate and phone number were recorded. The Steward recovery score was also recorded every five minutes during the first 20 minutes postoperatively and then every 10 to 15 minutes. Groups were similar regarding patient characteristics, depth of anaesthesia, sufentanil total dose, anaesthesia duration (D: 349.1±19.1 min; I: 349.2±22.9 min), haemodynamic/respiratory parameters, and surgical conditions (assessed by a bleeding score). The emergence time in the D group was significantly faster than the I group (D: 14.9±2.4 min vs I: 29.2±2.4 min for eye-opening). Full recovery also occurred earlier in the D group (D: 22.1± 3.1 min vs I: 37.6±4.0 min, P<0.005 for stating name). Steward recovery scores were also better during the first postoperative hour in the D group (D: 40 min vs I: 90 min, P<0.005 for 100% of patients with Steward score of 6). The results indicate that desflurane is associated with similar operating conditions and faster postoperative recovery following acoustic neuroma surgery. The faster recovery following desflurane may be desirable after long surgical procedures, enabling the patient's full cooperation and facilitating early diagnosis of any potential neurological deficit.

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SummaryWe compared the effects of the laryngeal mask and tracheal tube on total respiratory resistance in I0 anaesthetised, mechanically ventilated patients undergoing otological microsurgery. The subjects were randomly divided into two groups. In the first group, the tracheal tube (Riisch) 9.4(0.9)l.min-' and 8.1 (0.9) respectively). Leakage was avoided with the laryngeal mask because the insuflation pressure never exceeded 1.7 kPa except in one patient suflering from severe chronic obstructive pulmonary disease who had a total respiratory resistance of 1.45 kPa.1-'.s. During the first hour of the operation all respiratory variables remained stable irrespective of the device used. l.min-', respectively for end-tidal carbon dioxide concentrations between 3.6 and 4.1%. Although the glottic resistance was included in the measurement performed with the laryngeal mask but not with the tracheal tube, mean ( S E ) total respiratory resistance was not significantly dazerent with the two devices