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Rapid sequence induction in obstetrics revisited.

Lisa M Sharp¹, David M Levy

¹Nottingham and East Midlands School of Anaesthesia, Nottingham, UK.

Current Opinion in Anaesthesiology

|May 13, 2009

Summary

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Anesthesia for Cesarean section may evolve. A combination of rocuronium and sugammadex offers a potential replacement for succinylcholine, improving anesthetic practices.

Area of Science:

Anesthesiology
Obstetric Anesthesia

Background:

The thiopental, succinylcholine, and nitrous oxide/oxygen regimen for Cesarean section is 50 years old.
This review assesses the longevity and evolution of this anesthetic practice.

Purpose of the Study:

To review the historical anesthetic regimen for Cesarean section.
To evaluate current practices and predict future changes in obstetric anesthesia.

Main Methods:

Literature review of anesthetic techniques for Cesarean section.
Analysis of the enduring and evolving components of obstetric anesthesia.

Main Results:

Sugammadex enables rapid reversal of rocuronium-induced neuromuscular blockade.
The combination of high-dose rocuronium and sugammadex is a viable alternative.

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Conclusions:

Succinylcholine may be replaced in Cesarean sections.
Rocuronium-sugammadex offers a modern alternative to traditional anesthetic agents.