Evaluation of Large Language Models in Parasternal Block Ultrasound Interpretation

This prospective observational study aims to evaluate the accuracy of multimodal large language models (LLMs) in interpreting ultrasound recordings of superficial and deep parasternal intercostal plane blocks. Ultrasound recordings obtained during routine regional anesthesia procedures will be independently evaluated by LLMs using standardized prompts. Their ability to identify anatomical structures, assess local anesthetic spread, determine block success, and recognize potential procedural risks will be compared with expert anesthesiologist assessments. The study aims to investigate the potential role of LLMs in ultrasound-guided regional anesthesia assessment and clinical decision support.

Inclusion Criteria: * Patients aged 18-85 years. * American Society of Anesthesiologists (ASA) physical status I-III. * Undergoing elective surgery with an ultrasound-guided superficial or deep parasternal intercostal plane block. * Complete ultrasound video recording of local anesthetic injection. * Written informed consent for study participation. Exclusion Criteria: * Technical failure during block performance. * Inadequate ultrasound recording quality preventing clear visualization of the needle tip or local anesthetic spread. * Missing demographic data. * Withdrawal of informed consent at any stage of the study.