Aim of the work: Aim of work was to evaluate the effect of Neostigmine on hemodynamic when 
added to Bupivacaine for Brachial Plexus Block. Methods: This double-blinded randomized 
controlled clinical trial was carried out in Minia university hospital, faculty of medicine. The study 
included 80 patients, aged from (18-75) years, ASA I, II scheduled to undergo elective forearm and 
hand surgeries under ultrasound guided supraclavicular brachial plexus block. Results: The results of 
this study found that demographic (age, sex, weight and ASA classification and surgical duration)
were statistically insignificant between the two groups. Hemodynamics (HR) were statistically 
significant between the groups .They were lower in Neostigmine groups.