Rethinking the rapid sequence induction in obstetrics

SummaryThe use of general anaesthesia for caesarean delivery is decreasing, leading to less experience during anaesthesia training. Pregnant women have been known to be at higher risk for aspiration and difficult intubation. Rapid sequence induction is an integral dogma in the induction of general anaesthesia although several components of this process remain controversial. This review addresses several aspects, including the evidence for rapid sequence induction, use of cricoid pressure, choice of induction agent, use of succinylcholine, use of rocuronium with sugammadex for emergency neuromuscular blockade reversal and issues with opioid utilisation prior to delivery. The efficacy and safety of rapid sequence induction would be addressed.