A prediction model using machine-learning algorithm for assessing intrathecal hyperbaric bupivacaine dose during cesarean section.
BMC Anesthesiol
; 21(1): 116, 2021 04 14.
Article
em En
| MEDLINE
| ID: mdl-33853548
ABSTRACT
BACKGROUND:
The intrathecal hyperbaric bupivacaine dosage for cesarean section is difficult to predetermine. This study aimed to develop a decision-support model using a machine-learning algorithm for assessing intrathecal hyperbaric bupivacaine dose based on physical variables during cesarean section.METHODS:
Term parturients presenting for elective cesarean section under spinal anaesthesia were enrolled. Spinal anesthesia was performed at the L3/4 interspace with 0.5% hyperbaric bupivacaine at dosages determined by the anesthesiologist. A spinal spread level between T4-T6 was considered the appropriate block level. We used a machine-learning algorithm to identify relevant parameters. The dataset was split into derivation (80%) and validation (20%) cohorts. A decision-support model was developed for obtaining the regression equation between optimized intrathecal 0.5% hyperbaric bupivacaine volume and physical variables.RESULTS:
A total of 684 parturients were included, of whom 516 (75.44%) and 168 (24.56%) had block levels between T4 and T6, and less than T6 or higher than T4, respectively. The appropriate block level rate was 75.44%, with the mean bupivacaine volume [1.965, 95%CI (1.945,1.984)]ml. In lasso regression, based on the principle of predicting a reasonable dose of intrathecal bupivacaine with fewer physical variables, the model is "Y=0.5922+ 0.055117* X1-0.017599*X2" (Y bupivacaine volume; X1 vertebral column length; X2 abdominal girth), with λ 0.055, MSE 0.0087, and R2 0.807.CONCLUSIONS:
After applying a machine-learning algorithm, we developed a decision model with R2 0.8070 and MSE due to error 0.0087 using abdominal girth and vertebral column length for predicting the optimized intrathecal 0.5% hyperbaric bupivacaine dosage during term cesarean sections.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Algoritmos
/
Bupivacaína
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Técnicas de Apoio para a Decisão
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Aprendizado de Máquina
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Anestesia Obstétrica
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Raquianestesia
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Pregnancy
Idioma:
En
Revista:
BMC Anesthesiol
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
China