Abstract: The objective was to observe the hemodynamic changes after intravenous injection of neostigmine and atropine used for reversing the muscular relaxation. Methods: Twenty one neurosurgical patients, ASA class Ⅰ～Ⅱ, were randomly allocated into two groups. The mixture of neostigmine and atropine with 2∶1 (0.05 mg/kg∶0.025 mg/kg) in group Ⅰ or 3∶1 (0.05 mg/kg∶0.017 mg/kg) in group Ⅱ was given intravenously at the end of surgery with isoflurane pipecuronium anesthesia. The hemodynamic parameters were measured with transesophageal Doppler monitor (HEMOSONICTM 100) and Datex Cardiocap. Result: In both groups, HR increased significantly at 1, 2, 3 min after injecting the mixture of neostigmine and atropine. HR and peak velocity (PV) decreased significantly at 30 min after injection in group II. Other hemodynamic parameters did not change significantly after neostigmine and atropine were administered intravenously. Conclusion: 0.05 mg/kg neostigmine and 0.025 mg/kg atropine appear to be a better combination used for the neuromuscular reversal.

Key words: neostigmine, atropine, hemodynamics, transesophageal doppler