We read with interest the letter titled ‘Combating myths and misinformation’ by Norris.1 He has made some valid comments on the way in which statistical significance relates to clinical significance. His perspective on the results presented in our paper on induction opioids2 is that the reduction in Apgar scores caused by fentanyl is unlikely to be of any clinical significance. We believe that the difference in interpretation of the findings regarding fentanyl as an induction opioid for general anaesthesia (GA) for caesarean section (CS) stems from his initial clinical question. Norris appears to want to test the hypothesis that there is no harm associated with the use of fentanyl for the induction of a GA CS. This is different from our aim which was to establish a safety profile of various induction opioids, such as fentanyl. Therefore, the results for each opioid were required to show no difference in order to be deemed ‘safe’. We then presented evidence showing no difference in Apgar scores, respiratory intervention or neonatal intensive care admission for remifentanil and alfentanil. The studies reporting on fentanyl only assessed 1- and 5-min Apgar scores, without mention of respiratory interventions or neonatal intensive care admission.