Effect of nalbuphine and morphine as adjuvants to bupivacaine in ultrasound-guided supraclavicular block: a randomized controlled trial with machine learning-based predictive analysis
Abstract
BACKGROUND: Supraclavicular brachial plexus block is a commonly used regional anesthesia technique for upper extremity surgeries. The addition of adjuvants to local anesthetics enhances the duration and quality of anesthesia. Recently, Machine Learning (ML) has emerged as a tool for predictive modeling in medicine, including pain management. This study investigates the predictive capability of a K-Nearest Neighbor (KNN) ML model for analgesic duration using different drug combinations. METHODS: A prospective randomized controlled trial was conducted on 60 patients scheduled for upper limb surgeries under ultrasound-guided supraclavicular brachial plexus block. Patients were divided into three groups: Control (bupivacaine + saline), Nalbuphine (bupivacaine + nalbuphine), and Morphine (bupivacaine + morphine). The analgesic duration, sensory and motor block onset and duration, and postoperative analgesic use were recorded. A ML model, K-Nearest Neighbor (KNN), was developed to predict analgesic time based on demographic and hemodynamic parameters. RESULTS: Both nalbuphine and morphine significantly prolonged the duration of analgesia compared to the control group. The KNN model demonstrated a strong correlation (R = 0.95) between the observed and predicted analgesic duration, indicating high predictive accuracy. CONCLUSIONS: Nalbuphine and morphine significantly extended the analgesic duration of bupivacaine in ultrasound-guided supraclavicular brachial plexus block. ML…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 60 participants or records.
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