BACKGROUND: Anesthetic techniques for laryngeal microsurgery aims on modulation of sympathetic stimulation, good relaxation and rapid recovery from deep anesthesia. This study was designed to compare the influence of the different anesthetic methods on the cardiovascular responses and the recovery patterns during suspension laryngoscopic surgery. METHOD: Sixty patients of ASA class 1 or 2 scheduled for suspension laryngoscopic surgery were divided into 4 groups randomly. Two groups were anesthetized with inhalational anesthetic, enflurane, and other two groups were anesthetized with intravenous anesthetic, propofol. In each groups, esmolol or fentanyl was used as an adjunctive during anesthesia. When blood pressures increased above 30% of baseline value each adjunctive was added. The changes of blood pressure and heart rate were compared with each others during operation. Postoperatively, the start of spontaneous respiration, consciousness, memory, and the frequencies of other complications were also compared with each others. RESULT: The results were as follows; 1) The blood pressures and heart rates during operations were not different among the groups. 2) The recovery of spontaneous respiration was early in propofol esmolol group. 3) 30 minutes after operation, the consciousness state was better and complications were less in propofol groups compared with enflurane groups. CONCLUSION: From this results, it seems that propofol with nitrous oxide and supplemental fentanyl or esmolol may be useful in laryngeal microsurgery. Especially, esmolol can be a good substitute for those who can't be treated with opioids.