Establishing Obstetric Anesthesiology Practice Guidelines in the Republic of Armenia: A Global Health Collaboration

<zdoi;10.1097/ALN.0000000000001707> Anesthesiology, V 127 • No 2 220 August 2017 T HE global provision of safe anesthesia and surgery recently has become a priority.1 In 2015, the World Bank and the Lancet Commission on Global Surgery launched an appeal to address disparity in the availability and safety of surgery and anesthesia care between highand low-to-middle income countries.2,3 This has led to enhanced efforts to increase education and service initiatives to improve anesthesia safety and availability in highand low-to-middle income countries.1,3 High-income countries have promoted a culture of patient safety in part through the development of clinical practice guidelines. Practice guidelines are systematically developed recommendations to assist the practitioner in providing care. They are supported by analysis of the current literature or by expert opinion of practitioners in that field and modified as knowledge, technology, and practice evolve. The purpose of guidelines is to enhance quality, safety, and patient satisfaction.4 In the 1990s, interest in practice guidelines increased in the United States based on wide variations in clinical practice.5 The American Society of Anesthesiologists Practice Parameters Committee developed and published a series of guidelines. The tenth set of guidelines, on obstetric anesthesia, was published in 1999 and updated in 2007 and 2016.5 Similarly, practice guidelines for obstetric anesthesia have been published in other high-income countries and by the American College of Obstetricians and Gynecologists.6–9 Guidelines should provide a framework for the advancement of care after thorough review of the available evidence and practices within each local environment, be it in high-income countries or low-to-middle income countries. Guidelines developed by and for high-income countries may ABSTRACT