The objective was to compare the effect of three pharmacological agents on the hemodynamic response to suspended laryngoscopy in micro ENT Surgery. Double blind randomised prospective study having included: groupe A (n = 16) having benefited before laryngoscopy of 150 mcg/kg esmolol, groupe B (n = 16) 15 mcg/kg of nicardipine, groupe C (n = 15) 1 mg/kg of lidocaine and groupe D (n = 16), placebo group. All groups were comparable for demographic and anesthetic data. A significant reduction of the heart rate and pressure rate product were noted in esmolol group during the endoscopic act and maintained until arousal. Whereas there was no difference in the blood pressure during the procedure whatever the pharmacological agent for prevention of cardiovascular complications for patients to risk in micro ENT surgery.