Abstract: Objective To observe the effect of intravenous pre-injection of neostigmine on cardiovascular response(CVR) caused by neuromuscular electrical stimulation(NMES) in selective posterior rhizotomy(SPR) for patients with cerebral palsy.Methods 56 patients with cerebral palsy undergoing SPR at lumbarsacral segments under general anesthesia were randomly assigned to 2 groups: intravenous neostigmine 0.04 mg/kg(no more than 1 mg in total) and intravenous atropine 0.02 mg/kg(no more than 0.5 mg in total) 5 min before NMES in group N,and intravenous normal saline 0.12 ml/kg instead in group C.The systolic blood pressure(SBP) and heart rate(HR) at following time points: before skin incision(T₁),before intravenous neostigmine/atropine or normal saline injection(T₂),1 min after NMES(T₃),and 10 min after NMES(T₄).Results SBP and HR at T₃ in group N were significantly lower than those in group C(P<0.01).No significant difference was found at T₁,T₂ and T₄ between two groups(P>0.05).Cases who needed extra dose of fentanyl during NMES in group N were significantly lower than those in group C(P<0.01).Conclusion Intravenous pre-injection of neostigmine before NMES can effectively decrease the CVR caused by NMES.

Key words: neostigmine, selective posterior rhizotomy(SPR), neuromuscular electrical stimulation(NMES), cardiovascular response