Development and validation of machine learning models for predicting post-cesarean pain and individualized pain management strategies: a multicenter study

Abstract Background Effective management of postoperative pain remains a significant challenge in obstetric care due to the variability in pain perception and response influenced by physical, medical, and psychosocial factors. Current standardized pain management protocols often fail to accommodate...

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Main Authors: Shenjuan Lv, Ning Sun, Chunhui Hao, Junqing Li, Yun Li
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Anesthesiology
Subjects:
Online Access:https://doi.org/10.1186/s12871-025-03034-w
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author Shenjuan Lv
Ning Sun
Chunhui Hao
Junqing Li
Yun Li
author_facet Shenjuan Lv
Ning Sun
Chunhui Hao
Junqing Li
Yun Li
author_sort Shenjuan Lv
collection DOAJ
description Abstract Background Effective management of postoperative pain remains a significant challenge in obstetric care due to the variability in pain perception and response influenced by physical, medical, and psychosocial factors. Current standardized pain management protocols often fail to accommodate this variability, necessitating more tailored approaches. Objective This study aims to improve postoperative pain management following cesarean sections by developing personalized protocols using machine learning (ML) models. Method The study analyzed the efficacy of eight ML models, including XGBoost, Random Forest, and Neural Networks, using data from two distinct hospital cohorts. Performance metrics such as Root Mean Squared Error (RMSE) and Coefficient of Determination (R²) were evaluated through internal and external validations. SHAP value analysis was used to identify key predictors influencing pain management outcomes. Results The XGBoost model demonstrated superior performance, achieving the lowest RMSE and highest R². Key factors impacting pain management included esketamine use, anesthesia method, and anesthetic drug type, with esketamine significantly delaying the first activation of patient-controlled intravenous analgesia (PCIA). Conclusions The study highlights the potential of machine learning to refine postoperative pain management strategies in obstetric care, suggesting that personalized approaches, particularly incorporating esketamine and specific anesthesia methods, could enhance patient outcomes. Trial registration Not applicable.
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spelling doaj-art-19eb56a4df464badb35df00ccab814272025-08-20T02:17:02ZengBMCBMC Anesthesiology1471-22532025-04-012511910.1186/s12871-025-03034-wDevelopment and validation of machine learning models for predicting post-cesarean pain and individualized pain management strategies: a multicenter studyShenjuan Lv0Ning Sun1Chunhui Hao2Junqing Li3Yun Li4Department of Anesthesiology, Jinan Second Maternal and Child Health HospitalUltrasound Department, Jinan Second Maternal and Child Health HospitalDepartment of Anesthesiology, Jinan Second Maternal and Child Health HospitalUltrasound Department, Jinan Second Maternal and Child Health HospitalDepartment of Pain Management, Provincial Hospital Affiliated to Shandong First Medical UniversityAbstract Background Effective management of postoperative pain remains a significant challenge in obstetric care due to the variability in pain perception and response influenced by physical, medical, and psychosocial factors. Current standardized pain management protocols often fail to accommodate this variability, necessitating more tailored approaches. Objective This study aims to improve postoperative pain management following cesarean sections by developing personalized protocols using machine learning (ML) models. Method The study analyzed the efficacy of eight ML models, including XGBoost, Random Forest, and Neural Networks, using data from two distinct hospital cohorts. Performance metrics such as Root Mean Squared Error (RMSE) and Coefficient of Determination (R²) were evaluated through internal and external validations. SHAP value analysis was used to identify key predictors influencing pain management outcomes. Results The XGBoost model demonstrated superior performance, achieving the lowest RMSE and highest R². Key factors impacting pain management included esketamine use, anesthesia method, and anesthetic drug type, with esketamine significantly delaying the first activation of patient-controlled intravenous analgesia (PCIA). Conclusions The study highlights the potential of machine learning to refine postoperative pain management strategies in obstetric care, suggesting that personalized approaches, particularly incorporating esketamine and specific anesthesia methods, could enhance patient outcomes. Trial registration Not applicable.https://doi.org/10.1186/s12871-025-03034-wMachine learningPain managementPost-cesarean painSHAP valuesEsketamine
spellingShingle Shenjuan Lv
Ning Sun
Chunhui Hao
Junqing Li
Yun Li
Development and validation of machine learning models for predicting post-cesarean pain and individualized pain management strategies: a multicenter study
BMC Anesthesiology
Machine learning
Pain management
Post-cesarean pain
SHAP values
Esketamine
title Development and validation of machine learning models for predicting post-cesarean pain and individualized pain management strategies: a multicenter study
title_full Development and validation of machine learning models for predicting post-cesarean pain and individualized pain management strategies: a multicenter study
title_fullStr Development and validation of machine learning models for predicting post-cesarean pain and individualized pain management strategies: a multicenter study
title_full_unstemmed Development and validation of machine learning models for predicting post-cesarean pain and individualized pain management strategies: a multicenter study
title_short Development and validation of machine learning models for predicting post-cesarean pain and individualized pain management strategies: a multicenter study
title_sort development and validation of machine learning models for predicting post cesarean pain and individualized pain management strategies a multicenter study
topic Machine learning
Pain management
Post-cesarean pain
SHAP values
Esketamine
url https://doi.org/10.1186/s12871-025-03034-w
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