Errando C L, Pérez-Caballero P, Verdeguer-Ribes S, Vila-Montañés M
Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Unversitario, Valencia, España.
Rev Esp Anestesiol Reanim. 2013 Aug-Sep;60(7):371-83. doi: 10.1016/j.redar.2013.03.007. Epub 2013 May 31.
There are several treatment proposals for the obstetric patient with pre-eclampsia, but there is limited evidence on the adequacy of standard treatment. International healthcare organisations recommend that hospitals or anaesthesia departments have written guidelines, protocols or recommendations for dealing with common or severe situations. We propose evidence-based recommendations for the treatment of pre-eclampsia.
A literature review was performed using several sources, bibliography databases, recommendations made by specialist societies, and reviews. Four anaesthesiologists reviewed the references selected, in order to design clinical questions (these were obtained from recent pre-eclampsia review articles). Consensus of at least 3 out of 4 experts was required. The Oxford criteria for evidence were chosen to classify the scientific articles, and the Jadad score was applied to the final articles selected.
A total of 50 clinical questions were designed and answered. These were classified into: general questions, influence of the type of delivery, pre-anaesthesia evaluation, peripartum treatment (including analgesia and anaesthesia), eclampsia, post-delivery period, and intensive care and transport. Most of the responses showed low scientific evidence.
Evidence-based recommendations for severe pre-eclampsia treatment were provided with special emphasis on the anaesthesiologist point of view.
对于患有子痫前期的产科患者有多种治疗方案，但关于标准治疗的充分性证据有限。国际医疗组织建议医院或麻醉科针对常见或严重情况制定书面指南、方案或建议。我们提出基于证据的子痫前期治疗建议。
通过多种来源进行文献综述，包括书目数据库、专业学会的建议及综述。四位麻醉医生对所选参考文献进行评审，以设计临床问题（这些问题来自近期子痫前期综述文章）。要求四位专家中至少三位达成共识。选用牛津证据标准对科学文章进行分类，并将 Jadad 评分应用于最终选定的文章。
共设计并回答了 50 个临床问题。这些问题分为：一般问题、分娩方式的影响、麻醉前评估、围产期治疗（包括镇痛和麻醉）、子痫、产后时期以及重症监护和转运。大多数回答显示科学证据不足。
提供了基于证据的重度子痫前期治疗建议，特别强调了麻醉医生的观点。
