BACKGROUND: Desflurane is a new inhalation anesthetic with a low blood/gas solubility which should allow fast induction and emergence from anesthesia. This study was designed to compare the induction and recovery characteristics of gynecologic surgical patients receiving either desflurane or isoflurane with nitrous oxide for the maintenance of general anesthesia. METHODS: After standardized induction of anesthesia with fentanyl, propofol, succinylcholine and tracheal intubation, patients undergoing elective gynecologic surgery randomly divided into desflurane group (n=21) or isoflurane group (n=20). Induction and recovery time and the incidence of postoperative nausea and vomiting and recall were compared between the two groups. RESULTS: Although anesthetic conditions were similar during operation in the two groups, significant differences were noted in induction and recovery profiles from anesthesia. Induction time was 124+/-66 sec for desflurane vs. 422+/-257 sec for isoflurane (mean SD). The time required for the end-tidal concentration of anesthetics to decrease by 50% was 168.0+/-160.1sec for desflurane vs. 222.9+/-127.5sec for isoflurane. The time to response (eye opening follow simple command), orientation (recall of name and date of birth), reach 10 point of PAR (postanesthetic recovery) score and discharge from recovery room were significantly shorter after desflurane than after isoflurane (417.0+/-158.7 vs. 577.1+/-207.4sec, 591.0+/-193.0 vs. 800.0+/-326.0sec, 31.3+/-18.0 vs 41.8+/-15.0min, 66.9+/-27.2 vs. 80.1+/-11.8min, respectively). CONCLUSIONS: From the above study it can be concluded that a balanced anesthetic technique using desflurane as the main anesthetic has certain advantages compared with isoflurane in terms of faster emergence, however the frequency of side effects such as nausea, vomiting and recall during postoperative period were similar after both anesthetic drugs.