The authors present data on a comparative study of the effect of pyromecaine, cocaine and pontocaine during a number of otorhinolaryngeal operations. A device was developed for objective evaluation of anesthesia, which graphically records the extent and duration of anesthesia in patients. Pyromecaine was used during 420 operations and manipulations in 397 patients with diseases of the nose and nasal and paranasal sinuses aged from 14 to 82 years. The control group consisted of 200 patients subjected to the same operations with the use of cocaine and pontocaine. Data on algography and observations of the general condition in patients showed that 2% pyromecaine solution caused good anesthetic effect in 91%, satisfactory anesthetic effect in 8%, and unsatisfactory anesthetic effect in 1% patients. On the grounds of the conducted clinical studies the authors concluded that pyromecaine approaches pontocaine in respect to the extent and duration of its effect and exceeds cocaine by 2-2.5 times. They recommend pyromecaine for certain otorhinolaryngeal operations.