A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section

Abstract The aim of this study was to reveal the effects of anaesthesia strategies on maternal mean arterial pressure (MAP), heart rate, vasopressor consumption, adverse events, and neonatal resuscitation when women with preeclampsia (PE) undergo caesarean section (CS). Three major databases were se...

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Autores principales:	Chu Cheng, Alan Hsi-Wen Liao, Chien-Yu Chen, Yu-Cih Lin, Yi-No Kang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f1a3476dd4e141d28e6c586c58a1629d
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spelling	oai:doaj.org-article:f1a3476dd4e141d28e6c586c58a1629d2021-12-02T13:20:02ZA systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section10.1038/s41598-021-85179-52045-2322https://doaj.org/article/f1a3476dd4e141d28e6c586c58a1629d2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85179-5https://doaj.org/toc/2045-2322Abstract The aim of this study was to reveal the effects of anaesthesia strategies on maternal mean arterial pressure (MAP), heart rate, vasopressor consumption, adverse events, and neonatal resuscitation when women with preeclampsia (PE) undergo caesarean section (CS). Three major databases were searched for randomized controlled trials (RCTs) and prospective controlled studies (PCSs). Two authors independently screened, extracted, and checked eligibility and outcome data. Outcomes involved MAP, vasopressor use, maternal adverse events, APGAR scores, and neonatal resuscitation. Pooled estimates were carried out by contrast-based network meta-analysis, and pooled effect sizes were presented with 95% confidence interval (CI). Eleven RCTs and one PCS (n = 782) formed three-node network meta-analysis, and non-significant differences were observed in MAP, 5-min APGAR score, and neonatal intubation rate among the three anaesthesia strategies. General anaesthesia had significantly lower vasopressor consumption than spinal anaesthesia did (standardised mean difference = − 1.19, 95% confidence interval [CI]: − 1.76 to − 0.63), but it had higher maternal adverse event rate (risk ratio = 2.00, 95% CI 1.16–3.47). Because no optimal anaesthesia strategy has been shown to achieve a balanced maternal and neonatal outcome, therefore a shared decision-making process may be required regarding the most suitable choice of anaesthetic strategy for individual preeclamptic mother undergoing CS. Future larger studies may need to focus on evaluating the role of vasopressors on maternal hemodynamic as well as factors affecting maternal outcomes for different anaesthetic techniques in preeclamptic women undergoing CS.Chu ChengAlan Hsi-Wen LiaoChien-Yu ChenYu-Cih LinYi-No KangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chu Cheng Alan Hsi-Wen Liao Chien-Yu Chen Yu-Cih Lin Yi-No Kang A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section
description	Abstract The aim of this study was to reveal the effects of anaesthesia strategies on maternal mean arterial pressure (MAP), heart rate, vasopressor consumption, adverse events, and neonatal resuscitation when women with preeclampsia (PE) undergo caesarean section (CS). Three major databases were searched for randomized controlled trials (RCTs) and prospective controlled studies (PCSs). Two authors independently screened, extracted, and checked eligibility and outcome data. Outcomes involved MAP, vasopressor use, maternal adverse events, APGAR scores, and neonatal resuscitation. Pooled estimates were carried out by contrast-based network meta-analysis, and pooled effect sizes were presented with 95% confidence interval (CI). Eleven RCTs and one PCS (n = 782) formed three-node network meta-analysis, and non-significant differences were observed in MAP, 5-min APGAR score, and neonatal intubation rate among the three anaesthesia strategies. General anaesthesia had significantly lower vasopressor consumption than spinal anaesthesia did (standardised mean difference = − 1.19, 95% confidence interval [CI]: − 1.76 to − 0.63), but it had higher maternal adverse event rate (risk ratio = 2.00, 95% CI 1.16–3.47). Because no optimal anaesthesia strategy has been shown to achieve a balanced maternal and neonatal outcome, therefore a shared decision-making process may be required regarding the most suitable choice of anaesthetic strategy for individual preeclamptic mother undergoing CS. Future larger studies may need to focus on evaluating the role of vasopressors on maternal hemodynamic as well as factors affecting maternal outcomes for different anaesthetic techniques in preeclamptic women undergoing CS.
format	article
author	Chu Cheng Alan Hsi-Wen Liao Chien-Yu Chen Yu-Cih Lin Yi-No Kang
author_facet	Chu Cheng Alan Hsi-Wen Liao Chien-Yu Chen Yu-Cih Lin Yi-No Kang
author_sort	Chu Cheng
title	A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section
title_short	A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section
title_full	A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section
title_fullStr	A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section
title_full_unstemmed	A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section
title_sort	systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/f1a3476dd4e141d28e6c586c58a1629d
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A systematic review with network meta-analysis on mono strategy of anaesthesia for preeclampsia in caesarean section

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