Abstract
(Int J Obstet Anesth. 2019;40:4–13) Inducing general anesthesia (GA) for cesarean section (CS) can cause a significant sympathetic response that may then lead to serious adverse events, such as intracranial hemorrhage. Thus, administration of sympatholytic medications as part of the induction of GA would be desirable. While opioids are effective sympatholytic agents, older opioids may have adverse effects on the neonate. As a result their use has not been recommended during induction of GA for CS. Newer opioids are shorter-acting and it has been suggested they may have less adverse neonatal effects when used for GA induction for CS. However, more information is needed on their efficacy and potential adverse effects. This systematic review and meta-analysis was undertaken to evaluate the effects of shorter-acting induction opioids on Apgar scores, as well as other neonatal outcomes and their maternal sympatholytic efficacy.
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