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We conducted a randomized controlled trial to compare the recovery characteristics of selective spinal anesthesia (SSA) and desflurane anesthesia (DES) in outpatient gynecological laparoscopy. Twenty ASA physical status I patients undergoing gynecological laparoscopy were randomized to receive either SSA with lidocaine 10 mg + sufentanil 10 μg or general anesthesia with DES and N2O. Intraoperative conditions, recovery times, postanesthesia recovery scores, and postoperative outcomes were recorded. Intraoperative conditions were comparable in both groups. All patients in the SSA group were awake and oriented at the end of surgery, whereas patients in the DES group required 7 ± 2 min for extubation and orientation. SSA patients had a significantly shorter time to straight leg raising (3 ± 1 min versus 9 ± 4 min;P < 0.0001) and to ambulation (3 ± 0.9 min versus 59 ± 16 min;P < 0.0001) compared with the DES group. SSA patients had significantly less postoperative pain than DES patients (P < 0.05). We concluded that SSA was an effec-tive alternative to DES for outpatient gynecological laparoscopy.