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Rapid sequence induction in obstetrics revisited

Sharp, Lisa Ma; Levy, David Mb

Current Opinion in Anaesthesiology:
doi: 10.1097/ACO.0b013e3283294c4a
Obstetric and gynecological anesthesia: Edited by Marc Van de Velde

Purpose of review: The regimen of thiopental, succinylcholine (SCh) and unsupplemented nitrous oxide/oxygen for Caesarean section was first introduced 50 years ago. This review examines which elements have endured, what has changed, and how practice might alter in the very near future.

Recent findings: Sugammadex, a cyclodextrin, is capable of rapid reversal of profound rocuronium neuromuscular blockade.

Summary: It is now feasible that SCh might be replaced with a high-dose rocuronium–sugammadex combination.

Author Information

aNottingham and East Midlands School of Anaesthesia, UK

bNottingham University Hospitals NHS Trust, Nottingham, UK

Correspondence to Dr D.M. Levy, Anaesthetics Department, Queen's Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK Fax: +44 115 9783891; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.