الفهرس 
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Abstract
Aim Of The Work: This study was designed to evaluate haemodynamics and neuromuscular blocking effect of different doses of pipecuronium and atracurium combination .
Patients & methods: Sixty patients were included in this study of either sex .The patients were scheduled for major abdominal surgery and they were classified into three groups (each of 20).According to muscle relaxant given :first group received 0.08 mg /kg pipecuronium alone and second group received a combination of pipecuronium and atracurium in a dose of 0.04 and 0.25 mg/kg respectively .The third group received the same combination but in a dose of 0.026 and 0.166 mg/kg respectively .All the patients were pre medicated with 0.03 mg/kg midazolam and maintenance of anaesthesia were done by N2O in oxygen (2:1) and isoflurane 1:1.5 %.
Neuromuscular monitoring including onset of action of muscle relaxant ,assessment of intubation condition using intubation condition score,duration of bolus dose ,number of re doses ,duration of each re dose ,recovery times and total dose of muscle relaxant.
Routine intraoperative cardiovascular monitoring with ECG , non invasive arterial blood pressure and pulse oxymetry were performed at time of intubation ,10 ,30,60,120 minutes after intubation .
Conclusion: from this study we conclude that combination of atracurium and pipecuronium can be used to obtain acceptable onset time with duration of action similar to that of pipecuronium alone.