Kanuni Sultan Suleyman Training and Research Hospital

This multicenter, randomized, controlled study aims to compare the analgesic efficacy of Quadro Iliac Plane Block (QIPB) and Erector Spinae Plane (ESP) Block in lumbar vertebra surgeries. The study will evaluate postoperative pain management, opioid consumption, side effects, hospital stay duration, and patient satisfaction. Patients scheduled for single-level lumbar disk herniation surgery will be randomized to receive either the QIPB or ESP block before awakening from anesthesia. Pain scores will be measured at multiple postoperative time points, and opioid consumption will be monitored using patient-controlled analgesia (PCA). The study seeks to identify the most effective and safe method for postoperative pain management in lumbar surgeries.

Aim and Importance:
Regional anesthesia techniques have advanced significantly with the advent of ultrasound guidance. Peripheral nerve blocks and fascial plane blocks can now be performed safely and effectively under ultrasound visualization. Research has shown that ultrasound use significantly improves block success rates. However, accurate application requires in-depth knowledge of sonoanatomy, as failure to identify critical structures may result in incorrect anesthetic placement or failed blocks. While experienced anesthesiologists can easily identify these anatomical landmarks, those less familiar with sonoanatomy may find it challenging.
This study aims to evaluate the effectiveness of ChatGPT-4 in identifying sonoanatomical structures in ultrasound images. A secondary objective is to assess whether artificial intelligence can evaluate the accuracy of regional anesthesia applications.
Expected Benefits and Risks:
The primary benefit is to explore the potential of AI-based systems in improving the learning and application of sonoanatomy, which may help anesthesiologists perform more accurate and successful blocks. We believe that the findings could contribute to regional anesthesia training. The study poses no risks to participants.
Study Type, Scope, and Design:
This prospective, observational study will be conducted at Health Sciences University Istanbul Kanuni Sultan Süleyman Education and Research Hospital. Ultrasound images from patients aged 18 and older undergoing regional anesthesia under ultrasound guidance will be photographed, without collecting personal data. Detailed images of the ultrasound-guided block steps will be captured. The position and orientation of the ultrasound probe will be documented for the AI model.
A customized GPT-4 model will be developed to evaluate the sonoanatomical structures in the provided ultrasound images based on the probe's position and orientation. Additionally, the AI model will predict which block is being performed and assess the success of the block by analyzing the images. An experienced anesthesiologist will evaluate the accuracy of the AI's predictions.

This prospective, multicenter study will compare the postoperative analgesic efficacy of the Quadroiliac Plane Block (QIPB) and Pericapsular Nerve Group (PENG) block in patients undergoing femoral neck fracture surgery. Eligible patients will be randomly assigned to receive one of the blocks postoperatively under spinal anesthesia. The blocks will be administered by experienced anesthesiologists, and informed consent will be obtained from all participants.
Pain levels will be assessed using the visual analog scale (VAS) at rest and during movement at 0, 6, 12, and 24 hours post-surgery. Opioid consumption will be recorded through patient-controlled analgesia (PCA), and any need for rescue analgesia will be evaluated. Routine postoperative pain management will also include intravenous paracetamol.