AIM: To investigate the median effective dose (ED50) of low-dose sugammadex combined with glycopyrrolate and neostigmine in reversing muscle relaxation during intraoperative neurophysiological monitoring. METHODS: Thirty six patients with ASA grade II or III, aged between 18 and 80 years, were selected for elective resection of tumors in the cerebellopontine angle region under general anesthesia in our hospital, BMI 20-30 kg/m2. Anesthesia induction was administered with 0.60 mg/kg rocuronium bromide, and tracheal intubation was performed after TOF was 0. During the operation, muscle relaxation was maintained by pumping rocuronium bromide. When performing neurophysiological monitoring, the pumping of rocuronium bromide was stopped, TOF recovery to T2 appearance, the initial dose of sugammadex was 1 mg/kg combined with 4 μg/kg of glycopyrrolate and 0.02 mg/kg of neostigmine. An effective dose can be induced electrophysiological waveforms within 3 minutes. Otherwise, it is ineffective. The next patient is recommended to use 20% of the initial dose as a gradient to increase or decrease adjacent doses,the study ends until 8 dose inflection points are reached. Using SPSS 20 software, using Probit regression mode lto calculate ED50 and 95% confidence interval (95%CI). record HR and MAP before administration (T0) and 1 minute (T1), 3 minutes (T2), and 5 minutes (T3) after use, and intraoperative awareness, body movement rate, satisfaction with electrophysiological monitoring. RESULTS: A total of 36 patients were included in the analysis, and the Probit regression model calculated  ED50 1.338 mg/kg, 95%CI 0.838-1.786 mg/kg. The hemodynamics remained stable After administration, and the satisfaction rate of the neuroelectrophysiological monitoring doctor was 4.5±0.4. There was no intraoperative awareness or occurrence of body movements. CONCLUSION: Low dose sugammadex combined with glycopyrrolate and neostigmine can reverse muscle relaxation during intraoperative neurophysiological monitoring, with ED50 1.338 mg/kg and 95%CI 0.838-1.786 mg/kg.