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[16] Sevoflurane and desflurane causes reduction of CMR.[16] However, desflurane has more pronounced effect Roxadustat on increasing CBF and ICP than sevoflurane.[16] This should result in better brain relaxation with propofol and more brain swelling with desflurane anaesthesia. Our study demonstrates that the use of propofol, sevoflurane and desflurane have similar and acceptable effects on the brain relaxation scores at various stages of surgery. Similarly, no difference was found in the various studies conducted previously with the use of similar anaesthetic agents.[3,5,13,17] A recent meta-analysis shows that propofol-based anaesthesia is associated with lower initial ICP when compared to the volatile agent maintained anaesthesia.[18] However, this did not translate into better brain relaxation scores with use of propofol in comparison to volatile agent based anaesthesia.[18] One of the largest trial comparing three http://www.selleckchem.com/Androgen-Receptor.html different anaesthetic techniques (propofol/fentanyl, isoflurane/nitrous oxide and fentanyl/nitrous oxide) could not demonstrate the superiority of one anaesthetic over the other with regards to either reduction of ICP or improved brain relaxation scores in patients undergoing elective supratentorial craniotomy.[2] The emphasis in present clinical practice is to facilitate early awakening along with improved quality of emergence.[6,19] Early awakening Adenylate cyclase allows for a timely detection of a neurological complication and reintervention if necessary. Emergence time in our study was the time from switching off of N2 O to extubation following which the patient can be subjected to neurological examination. The emergence time, which should be considered reasonable to facilitate early neurological evaluation has been suggested as 15 min.[6] Desflurane has the advantage of fast offset and recovery due to its low blood gas partition coefficient as compared to sevoflurane.[10] Recovery from propofol is rapid due to its short context-sensitive half-time and the decline in blood concentration required for awakening is somewhat