PDF(Pubmed)
Abstract：
OBJECTIVE: This consensus statement presents a comprehensive and evidence-based set of guidelines that modify the general European or US guidelines for hypotension management with vasopressors during cesarean delivery. It is tailored to the Southeast Asian context in terms of local human and medical resources, health system capacity, and local values and preferences.
RESULTS: These guidelines were prepared using a methodological approach. Two principal sources were used to obtain the evidence: scientific evidence and opinion-based evidence. A team of five anesthesia experts from Vietnam, the Philippines, and Thailand came together to define relevant clinical questions; search for literature-based evidence using the MEDLINE, Scopus, Google Scholar, and Cochrane libraries; evaluate existing guidelines; and contextualize recommendations for the Southeast Asian region. Furthermore, a survey was developed and distributed among 183 practitioners in the captioned countries to gather representative opinions of the medical community and identify best practices for the management of hypotension with vasopressors during cesarean section under spinal anesthesia.
CONCLUSIONS: This consensus statement advocates proactive management of maternal hypotension during cesarean section after spinal anesthesia, which can be detrimental for both the mother and fetus, supports the choice of phenylephrine as a first-line vasopressor and offers a perspective on the use of prefilled syringes in the Southeast Asian region, where factors such as healthcare features, availability, patient safety, and cost should be considered.
RESULTS: These guidelines were prepared using a methodological approach. Two principal sources were used to obtain the evidence: scientific evidence and opinion-based evidence. A team of five anesthesia experts from Vietnam, the Philippines, and Thailand came together to define relevant clinical questions; search for literature-based evidence using the MEDLINE, Scopus, Google Scholar, and Cochrane libraries; evaluate existing guidelines; and contextualize recommendations for the Southeast Asian region. Furthermore, a survey was developed and distributed among 183 practitioners in the captioned countries to gather representative opinions of the medical community and identify best practices for the management of hypotension with vasopressors during cesarean section under spinal anesthesia.
CONCLUSIONS: This consensus statement advocates proactive management of maternal hypotension during cesarean section after spinal anesthesia, which can be detrimental for both the mother and fetus, supports the choice of phenylephrine as a first-line vasopressor and offers a perspective on the use of prefilled syringes in the Southeast Asian region, where factors such as healthcare features, availability, patient safety, and cost should be considered.
摘要：
目的：这份共识声明提出了一套全面的、以证据为基础的指南，修改了欧洲或美国关于剖宫产期间血管加压药低血压管理的一般指南。在当地人力和医疗资源方面，它是根据东南亚背景量身定制的，卫生系统能力，以及当地的价值观和偏好。
结果：本指南采用方法学方法编写。使用两个主要来源来获取证据：科学证据和基于意见的证据。一个由五名来自越南的麻醉专家组成的团队，菲律宾,和泰国一起定义相关的临床问题；使用MEDLINE搜索基于文献的证据，Scopus,谷歌学者，和Cochrane图书馆；评估现有指南；并为东南亚地区提出建议。此外，我们制定了一项调查,并在标题国家的183名从业者中进行了调查,以收集医学界的代表性意见,并确定脊髓麻醉下剖宫产期间血管加压药低血压的最佳管理方法.
结论：这一共识主张主动管理剖宫产术后产妇低血压，这对母亲和胎儿都有害，支持选择去氧肾上腺素作为一线血管加压药，并提供了在东南亚地区使用预充式注射器的观点，在医疗保健功能等因素中，可用性,患者安全,应该考虑成本。
结果：本指南采用方法学方法编写。使用两个主要来源来获取证据：科学证据和基于意见的证据。一个由五名来自越南的麻醉专家组成的团队，菲律宾,和泰国一起定义相关的临床问题；使用MEDLINE搜索基于文献的证据，Scopus,谷歌学者，和Cochrane图书馆；评估现有指南；并为东南亚地区提出建议。此外，我们制定了一项调查,并在标题国家的183名从业者中进行了调查,以收集医学界的代表性意见,并确定脊髓麻醉下剖宫产期间血管加压药低血压的最佳管理方法.
结论：这一共识主张主动管理剖宫产术后产妇低血压，这对母亲和胎儿都有害，支持选择去氧肾上腺素作为一线血管加压药，并提供了在东南亚地区使用预充式注射器的观点，在医疗保健功能等因素中，可用性,患者安全,应该考虑成本。
