Best practice in obstetric general anaesthesia: an umbrella review of pharmacological strategies for induction of general anaesthesia
Authors' conclusion
Current evidence supports the safety of short-acting opioids, propofol as the preferred induction drug and rocuronium as a suitable alternative to suxamethonium during induction of anaesthesia for caesarean delivery.
Study context
- Population
- Women undergoing GA for caesarean delivery7 meta-analyses · 2 SRs · 26 RCTs · 15 observational studies
- Comparison
- Pharmacological strategies for induction of GA for caesarean delivery
Methodological detailsevidence certainty evaluation, 7 meta-analyses, 2 systematic reviews, 26 RCTs and 15 observational studies included
- Evidence certainty evaluation
- 7 meta-analyses, 2 systematic reviews, 26 RCTs and 15 observational studies included
Main finding
As reported in the abstract
- Short-acting opioids offered maternal haemodynamic benefit without negative neonatal consequences (moderate quality evidence)
- Propofol vs thiopental: equivalent early neonatal resuscitation requirements, lower risk of maternal accidental awareness (low quality evidence)
- Labetalol, dexmedetomidine, lidocaine and remifentanil attenuated maternal haemodynamic response to laryngoscopy, with minimal neonatal adverse effects
- Rocuronium ≥ 1 mg.kg-1 provided comparable tracheal intubation conditions to suxamethonium without affecting neonatal outcomes (moderate quality evidence)
Original publication
Best practice in obstetric general anaesthesia: an umbrella review of pharmacological strategies for induction of general anaesthesia. Anaesthesia. Published 16 April 2026. doi:10.
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