Enhancing barrier properties of cellulose propionate films through the integration of ionic liquid: A study on water pressure resistance.

This study pioneers the production of porous cellulose propionate (CP) films enhanced with tetrabutylammonium styrenesulfonate ([N4444][SS]), an ionic liquid, to bolster their resistance against water pressure. In contrast to polymer films with ionic liquids that have high moisture permeability, the CP/[N4444][SS] films exhibit remarkable water resistance even under 8 bar pressure. This is due to the physical cross-linking between the [N4444] ions and CP's polar groups, limiting CP chain mobility and thus reducing water interaction. Fourier-transform infrared spectroscopy confirmed these interactions, while scanning electron microscopy revealed a dense, unconnected porous structure. Thermogravimetric and differential scanning calorimetry analyses showed that adding [N4444][SS] increases the CP film's glass transition temperature, indicating enhanced thermal stability. Overall, the study demonstrates that integrating an ionic liquid into CP films significantly improves their barrier capabilities against water and pressure, which has broad implications for various industrial applications.

Genetic Variants Associated with Body Mass Index Changes in Korean Adults: The Anseong and Ansan Cohorts of the Korean Genome and Epidemiology Study.

Although previous studies have examined the relationship between obesity and genetics in response to the growing obesity epidemic, research on the relationship between obesity and long-term changes in body mass index (BMI) is limited. To investigate this relationship, data from 1030 cases in the Anseong and Ansan cohorts were collected from the Korean Genome and Epidemiology Study conducted by the Korea National Institute of Health between 2000 and 2014. Cases lacking participants' BMI data throughout the study were excluded, resulting in a final sample size of 3074. An increase or decrease in BMI was analyzed using PLINK, STRING, and DAVID, with significant differences observed in the AEN, ANKS1B, CSF1, EEF2K, FRAS1, GRIK4, PDGFC, THTPA, and TREH genes. These genes were observed to cluster with pathways related to type 2 diabetes, cardiovascular disease, metabolic processes, and endocytosis-related genes. These results suggest that several genes are involved in BMI changes and that several pathways are associated with obesity risk. Moreover, some genetic variants appear to influence BMI changes in Korean adults.

Relationship between recurrence and age in the diffuse sclerosing variant of papillary thyroid carcinoma: clinical significance in pediatric patients.

Background: The diffuse sclerosing variant (DSV) is among the aggressive variants of papillary thyroid carcinoma (PTC) and is more prevalent in pediatric patients than in adult patients. Few studies have assessed its characteristics owing to its low incidence. We aimed to evaluate the relationship between recurrence and age in the DSV of PTC. Methods: We retrospectively reviewed patients diagnosed with the DSV or conventional PTC (cPTC) after surgery at a medical center between May 1988 and January 2019. We compared the clinico-pathological characteristics and surgical outcomes of the DSV and cPTC groups and between adult and pediatric patients with DSV. Results: Among the 24,626 patients, 202 had the DSV, and 24,424 were diagnosed with cPTC. The recurrence rate was significantly higher in the DSV group than in the cPTC group. In the DSV group, the recurrence rate was significantly higher in the pediatric patient group than in the adult patient group. Moreover, the association between recurrence and age group showed different patterns between the DSV and cPTC groups with restricted cubic splines (RCS). While both RCS curves showed a U-shaped distribution, the RCS curve tended to be located within the younger age group. Conclusions: This study demonstrated that pediatric patients with DSV are at a greater risk for recurrence compared with adult patients; moreover, the pattern of recurrence risk according to age is different from that of cPTC.

Minimally Invasive Open Bilateral Total Thyroidectomy Using Unilateral Neck Incision in Thyroid Cancer: Preliminary Surgical and Quality of Life Outcomes.

PURPOSE: Thyroid cancer incidence has increased in recent decades, and thyroid surgery is continuously evolving in response to demands for postoperative comfort and cosmesis. This study aimed to introduce a new surgical method for minimally invasive open bilateral total thyroidectomy (MI-BTT) using a unilateral 2.5-3.0 cm neck incision. Furthermore, we reported the surgical outcomes and postoperative quality of life (QoL) using a validated Korean translated Dermatology Life Quality Index (DLQI) questionnaire. MATERIALS AND METHODS: We retrospectively evaluated 41 Asian patients who underwent MI-BTT for low-risk papillary thyroid cancer by a single surgeon from March 2019 to December 2021. RESULTS: A total of 4 male and 37 female patients were included. The mean age and body mass index were 46.2±10.1 years and 23.3±3.3 kg/m², respectively. The average tumor size was 1.1±0.6 cm, and 36 patients (87.8%) had bilateral cancer. Twenty-three (56.1%) patients had occult central lymph node (CLN) metastasis in the final pathologic report, with the mean number of dissected CLNs being 7.2±6.5. Gross capsular extension was found in 6 patients (14.6%). Moreover, 28 patients (68.3%) received additional treatment after surgery with low or high doses of radioactive iodine. The average serum-stimulated thyroglobulin value identified during treatment was 1.57±2.30 ng/mL. The mean operation time was 78.0±13.9 minutes, and postoperative complications included transient hypocalcemia (36.6%), transient hoarseness (24.4%), and seroma (2.4%). The mean total DLQI score was 2.73±0.78, indicating a small effect on QoL. CONCLUSION: MI-BTT is a novel, safe, and feasible technique to improve patient satisfaction for surgical scars and QoL.

Innovative eco-friendly hydroxyethylcellulose matrix-based composite for enhanced gas separation: Insights from performance and structural characterization.

With increasing concern for the environment, the demand for carbon dioxide separation, a key contributor to global warming, has escalated. Therefore, this paper focuses on carbon dioxide separation by creating an hydroxyethyl cellulose (HEC)(C2H6O2)x*(C6H7O2(OH)3)n/silver tetra fluoroborate (AgBF4)/aluminum nitrate (Al(NO3)3) composite film, demonstrating excellent separation performance with a permeance of 1.0 GPU and a selectivity of 100. Silver ions enhance the solubility of carbon dioxide, aiding in its separation, and we determined the optimal aluminum composition to stabilize the silver ions. To analyze this, we examined the cross-sections using SEM, confirming a selective layer of 1.7 µm for carbon dioxide separation. Furthermore, TGA, FT-IR, and NMR analyses were conducted to investigate the interaction between the polymer and additives. This revealed that the increased polymer chain due to the interaction between Ag and HEC, along with stabilized Ag facilitated by the addition of Al, maximized the interaction with carbon dioxide via the empty s-orbital. Additionally, SEM-EDX, UV-vis, XRD, XPS analyses were employed to elucidate the movement of ions within the membrane. These results provide insights into the performance of membranes based on cellulose polymer and offer valuable insights for future applications in gas separation technologies.

Enhancing CA-based separators with thermo-responsive ionic liquids: A path to eco-friendly membrane production and multifaceted applications.

We synthesized a temperature-responsive ionic liquid, [N4444][SS], and incorporated it into an environmentally friendly cellulose acetate (CA)-based battery separator. A pore was formed in the battery separator by [N4444][SS], which pierced a plasticized part due to water pressure. Varying drying temperatures during membrane fabrication revealed that the CA/[N4444][SS] membrane dried at 50 °C exhibited greater thickness and a smaller average pore size, resulting in an asymmetric internal structure. Despite the asymmetry, this membrane demonstrated significantly higher water flux and a lower Gurley value compared to the membrane dried at 25 °C, indicating minimal tortuosity and low resistance within the internal pores. Thermal behavior analysis through TGA and DSC, as well as FT-IR spectroscopy, confirmed that [N4444][SS] remains within the CA matrix, forming coordinative bonds. The findings suggest that the CA/[N4444][SS] membrane, when used as a Li-ion battery separator, could enhance Li-ion transport properties and conductivity. Moreover, the recyclability of the IL in the membrane fabrication process contributes to a more environmentally friendly approach.

Association between Consumption of Iodine-Rich Foods and Thyroid Cancer Prevalence: Findings from a Large Population-Based Study.

The influence of iodine-rich foods on thyroid cancer (TC) risk remains inadequately understood. Therefore, we aimed to comprehensively investigate the relationship between three iodine-rich food groups and TC prevalence using extensive data from a large Korean population. We assessed the dietary intake of 169,057 participants in the Korean Genome and Epidemiology Study (2004-2013) using a food frequency questionnaire. The top-three iodine-rich food groups (including egg, seaweed, and dairy) were selected based on Korean dietary reference intakes and categorized by weekly consumption frequency. We conducted multiple logistic regression models to examine the relationship between food consumption and TC prevalence. After adjusting for confounding factors, higher seaweed consumption (>5 times/week) was significantly associated with lower TC prevalence (odds ratio [OR], 95% confidence interval [CI] = 0.42, 0.32-0.56, p-value < 0.001). In contrast, compared with moderate dairy consumption (3-4 times/week), lower dairy product intake (<1 time/week) was associated with higher TC prevalence (OR, 95% CI = 1.32, 1.05-1.67, p-value = 0.017). Our findings suggest that sufficient seaweed consumption may offer protection against TC, and incorporating dairy products into the diet may lower TC incidence in the Korean population. The most significant limitations of our study are the absence of 24 h urine samples for iodine status assessment and the lack of clinical data on the diagnosis of thyroid cancer.

Protective Role of Rapamycin in Fibrotic Liver Ischemia/Reperfusion Injury (C57bl/6 Mouse).

BACKGROUND: Liver ischemia/reperfusion injury (IRI) is a well-documented phenomenon that occurs after liver resection and transplantation, posing a significant clinical challenge. We aim to contribute valuable insights into potential therapeutic interventions for fibrotic liver IRI, ultimately advancing our understanding of liver transplantation and resection outcomes. METHODS: Twenty-four mice were divided randomly into 4 equal groups: [1] the normal group, n = 6; [2] the liver fibrosis (LF) group, n = 6; [3] the LF and IR group, n = 6; and [4] the LF with treatment of rapamycin and IR group; n = 6. RESULTS: Key biomarkers assessing liver function, alanine aminotransferase and aspartate aminotransferase, significantly decreased with Rapamycin administration. There is a substantial decrease observed in inflammatory cytokines such as interleukin (IL) 6, IL-1B, tumor necrosis factor alpha, Transforming growth factor-beta (TGF-beta), and Inducible nitric oxide synthase (iNOS) with rapamycin treatment. Furthermore, NOX levels, caspase-3, and caspase-9 were reduced after rapamycin administration. CONCLUSION: The application of rapamycin demonstrates appropriate effects in anti-inflammation, antioxidation, and anti-apoptosis, indicating significant therapeutic potential for fibrotic liver IRI.

Expansion of thyroid surgical territory through 10,000 cases under the da Vinci robotic knife.

With the progress of robotic transaxillary thyroid surgery (RTTS), the indications for this procedure have gradually expanded. This study presents the insights gained from performing 10,000 RTTS cases at a single institution, along with the expansion of indications over time. RTTS was performed on 10,000 patients using the da Vinci robot system between October 2007 and April 2023 at the Yonsei University Health System, Seoul, Korea. Among 10,000 patients, 9461 (94.0%) were diagnosed with thyroid cancer, whereas 539 (5.4%) had either a benign thyroid nodule or Graves' disease. Surgical procedures were performed using four-arm-based robots (da Vinci S, Si, or Xi) for 8408 cases (84.1%), with the remaining 1592 cases (15.9%) being performed using the da Vinci SP surgical robotic system. Notably, for 53 patients with nodules ≥ 5 cm, which were not included in the eligibility criteria of the previous study, RTTS was performed safely without significant complications. The most common postoperative complication was transient hypoparathyroidism (37.91%), and recurrence occurred in 100 patients with thyroid cancer (1.1%). In conclusion, RTTS appears safe and feasible from both surgical and oncological perspectives, and the spectrum of indications suitable for RTTS surgery is progressively expanding.

Influence of citric acid concentrations on the porosity and performance of cellulose acetate-based porous membranes: A comprehensive study.

This study investigates the influence of citric acid concentration on the fabrication of porous cellulose acetate (CA) membranes using the Non-Solvent Induced Phase Separation (NIPS) method. A notable aspect is the precise control over membrane properties, particularly pore size and porosity, achieved solely through the adjustment of citric acid concentration, serving as the additive. Higher concentrations of citric acid increase pore size by rendering polymer chains more pliable, whereas lower concentrations lead to smaller, denser pores due to improved dispersion in the CA matrix and altered water interactions during phase separation. A decrease in porosity and Gurley values with reducing citric acid concentrations (from 5 × 10-2 to 1 × 10-3 M ratios) indicates less plasticization of CA chains. However, at very low concentrations (1 × 10-4 and 1 × 10-5), porosity increases, despite the presence of smaller pores, and Gurley values approach those of pure CA in terms of gas permeability. Fourier Transform Infrared (FT-IR) spectroscopy confirms the presence of citric acid and its interaction with carbonyl groups, consistent with the pore size observations from Scanning Electron Microscopy (SEM). Spectral data deconvolution reveals weakened carbonyl bonds due to the reduced presence of citric acid, correlating with the smaller pores observed in SEM. Thermal Gravimetric Analysis (TGA) demonstrates that composite membranes are more thermally stable than pure CA, attributed to the citric acid-induced crosslinking within the polymer chains. Stability increases with decreasing citric acid concentration, with some anomalies at the lowest levels. In conclusion, this study highlights the capability of adjusting citric acid concentration to tailor membrane properties, offering valuable insights for the creation of porous materials across diverse industrial applications.

Derivation of porous cellulose propionate using hydrated hydroxyl groups and hydraulic pressure.

This study aimed to enhance the thermal stability of microporous separators by introducing cellulose propionate (CP) as an innovative polymer matrix material, supplemented with glycerin as an additive. CP/glycerin composite membranes were created using hydraulic pressure techniques to reinforce essential separator properties. SEM analysis unveiled interconnected pores crucial for efficient ion transport, initiating water flux measurements at 5 bar. These measurements showcased improved mechanical strength, resulting in a porosity of 74.1 %. FT-IR spectroscopy illustrated CP-glycerin interactions, inducing plasticization and facilitating pore formation. Thermal Gravimetric Analysis (TGA) demonstrated superior thermal stability in CP/glycerin composite membranes compared to cellulose acetate (CA). Differential Scanning Calorimetry (DSC) revealed a slight reduction in thermal stability within a specific temperature range due to glycerin-induced plasticization effects. Nonetheless, the melting temperature (Tm) of CP/glycerin membranes increased to 188.4 °C, indicating heightened stability at elevated temperatures. Despite pressure-induced pore formation, CP/glycerin membranes exhibited enhanced thermal stability, suggesting reinforced molecular interactions. Overall, this study introduces a novel CP/glycerin composite membrane featuring improved thermal stability, enhanced strength, and controlled pore structures essential for efficient lithium-ion battery applications.

Mass transport to generate the channels in cellulose polymers by vacuum-assisted process.

This study developed a pore-connected PP-CA membrane by coating cellulose acetate onto a polypropylene filter. A new method was proposed to attach a CA/glycerin coating layer to a porous PP support without a separate binder. The pores of CA and PP were interconnected using a vacuum filtration device. By adding glycerin to the CA chains, the membrane region became more flexible due to glycerin plasticization. Water passed through the membrane under pressure differences, resulting in the formation of interconnected pores between cellulose acetate and polypropylene. The pore size and quantity could be adjusted by varying the molar ratio of glycerin. Fourier transform infrared spectroscopy revealed the interaction between CA and glycerin, while thermogravimetric analysis showed that the membrane's thermal stability increased by approximately 20 °C after vacuum filtration. This simple and cost-effective manufacturing process holds potential for mass-producing separators in the lithium-ion battery industry.

Effect of orodispersible hyaluronic acid film on palatal mucosa wound healing.

OBJECTIVE: The objective of the study was to evaluate the healing effect of hyaluronic acid films on palatal wounds. MATERIALS AND METHODS: After making 5-mm diameter palatal wounds, 72 rats were randomly assigned to three groups: control, hyaluronic acid gel, and hyaluronic acid film. The animals were sacrificed at 3, 7, and 21 days after the experiment. Clinical, histological, and RT-PCR analyses were performed. Human ex vivo oral mucosa models were used. Histological analysis and pan-cytokeratin staining were performed at 5 days after wound creation. RESULTS: In rat model, both gels and films showed favorable healing on Days 3 and 7 compared with healing in the control (p < 0.05). Film showed remarkable VEGF and α-SMA expression than did the others (p < 0.05). Immunohistochemical analysis showed that film exhibited significantly lower CD68 and greater α-SMA and vimentin expression levels than those in the others (p < 0.05). In human model, re-epithelialization rate of film group was significantly higher than that of the others. Complete epithelial regeneration was confirmed only in film group using pan-cytokeratin staining. CONCLUSIONS: Within the limits of this study, hyaluronic acid film outperformed gels in terms of palatal wound healing in both models.

Effect of intra-alveolar delivery of Frondoside A on inflammatory response of delayed tooth replantation.

BACKGROUND/AIM: Frondoside A is a sea cucumber extract which is well known for its anti-inflammatory and immunomodulatory properties. The purpose of this study was to evaluate the effect of Frondoside A application in the alveolar socket on inflammatory responses after delayed replantation in rat teeth. MATERIALS AND METHODS: Human periodontal ligament cells were cultured and exposed to Frondoside A. Cell-counting kit-8 assay was performed to evaluate the cell viability and nitric oxide assay was performed to assess the anti-inflammatory effect of Frondoside A. Molars were extracted from 32 Sprague-Dawley rats and randomly divided into control and Frondoside A groups. After 30 min of extra-oral dry time, molars were replanted. In the Frondoside A group, Frondoside A solution was applied in the alveolar socket before replantation. The animals were sacrificed after 28 days and histologically and immunohistochemically evaluated. RESULTS: 0.5 µM Frondoside A showed higher cellular viability at 6 h and lower production of nitric oxide compared with other Frondoside A solutions (p < .05). The Frondoside A group demonstrated lower inflammatory resorption scores in both middle 1/3 and apical 1/3 of root compared to the control group (p < .05). The Frondoside A group showed lower levels of expression in both cathepsin K and CD45 compared with the control group (p < .05). CONCLUSIONS: Within the limits of this study, intra-alveolar delivery of Frondoside A alleviates inflammatory root resorption in delayed replantation of rat teeth.

Channels formation in cellulose materials by accelerated transport of gas molecules and glycerin.

In this study, a microporous separator was produced using cellulose acetate (CA), which demonstrates heightened thermal stability in comparison to existing materials like polypropylene (PP) or polyethylene (PE). Furthermore, a pliable component was integrated into the CA membrane using glycerin as the plasticizing agent. Subsequently, gas pressure was exerted onto these areas to induce the formation of nano-sized pores. Examination through Scanning Electron Microscopy (SEM) unveiled the presence of abundant pores in the glycerin-plasticized areas. This substantiates that the pores generated under gas pressure were not only more uniform but also smaller than those created under water pressure. The interaction between CA and glycerin was validated using Fourier-Transform Infrared Spectroscopy (FT-IR), offering confirmation that a portion of the glycerin was extracted following the application of gas pressure. Additionally, the application of Thermogravimetric Analysis (TGA) allowed for an assessment of the thermal stability of the CA membrane, along with a verification of glycerin's removal post gas pressure treatment. The findings indicated that the incorporation of glycerin diminished the thermal stability of the CA membrane due to the plasticization effect. Furthermore, it was observed that a minor quantity of glycerin still persisted after the gas pressure treatment. Following the analysis of gas permeation, the porosity of the CA membrane was quantified at 78.8 %, exhibiting an average pore size measuring 224 nm.

The effects of perioperative dexmedetomidine infusion on hemodynamic stability during laparoscopic adrenalectomy for pheochromocytoma: a randomized study.

Introduction: Pheochromocytoma is a rare catecholamine-producing neuroendocrine tumor originating from the adrenal medulla chromaffin cells. Hemodynamic instability can occur during the induction of anesthesia and surgical manipulation of the tumor. This study investigated the effects of intraoperative dexmedetomidine administration on hemodynamic stability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma. Methods: Forty patients who underwent laparoscopic adrenalectomy for pheochromocytoma were randomly assigned to the dexmedetomidine (n = 20) or control (n = 20) group. The primary outcome of this study was intraoperative hemodynamic stability, and the secondary endpoint was the plasma catecholamine concentrations, specifically of epinephrine and norepinephrine. Results: The intraoperative maximum blood pressures were significantly lower in the dexmedetomidine group (control vs. dexmedetomidine group: 182 ± 31 vs. 161 ± 20, 102 ± 17 vs. 90 ± 10, and 128 ± 22 vs. 116 ± 12 [mean ± SD] mmHg and p = 0.020, 0.015, and 0.040 for systolic, diastolic, and mean blood pressure, respectively). The maximum heart rate during surgery was 108 ± 15 bpm in the control group and 95 ± 12 bpm in the dexmedetomidine group (p = 0.010). Other parameters of hemodynamic instability were comparable between both groups. Plasma catecholamine concentrations did not differ between the groups. Conclusion: Dexmedetomidine infusion following the induction of anesthesia at a rate of 0.5 µg/kg/h significantly attenuated the maximum intraoperative SBP, DBP, MBP, and HR, contributing to improved hemodynamic stability.

Gas transport into cellulose materials for highly porous structure.

To solve the low thermal stability of polyolefin membranes, our group developed porous polymers using cellulose acetate (CA) material. The formation of pores in CA involved creating plasticized regions within the CA membrane using additives. By applying gas pressure to these regions, a CA/glycolic acid membrane could be prepared with a small average pore size and high porosity. According to the porosimeter measurement, the average pore size of the membrane was 150 nm, and the porosity was 77%. SEM observations of the surface and cross-section of the CA/glycolic acid membrane confirmed the abundant distribution of fine pores. Furthermore, IR analysis revealed the removal of glycolic acid from the membrane after pore formation, indicating its interaction with CA during the process of gas permeation. Additionally, TGA analysis demonstrated a decrease in thermal stability due to the formation of numerous pores after gas permeation.

Do large thyroid nodules (≥4 cm) without suspicious cytology need surgery?

Background: Fine-needle aspiration biopsy (FNAB) is a good diagnostic tool for thyroid nodules; however, its high false-negative rate for giant nodules remains controversial. Many clinicians recommend surgical resection for nodules >4 cm owing to an increased risk of malignancy and an increased false-negative rate. This study aimed to examine the feasibility of this approach and investigate the incidence of malignancy in thyroid nodules >4 cm without suspicious cytology based on medical records in our center. Methods: This was a retrospective analysis of 453 patients that underwent preoperative FNAB for nodules measuring >4 cm between January 2017 and August 2022 at Severance Hospital, Seoul. Results: Among the 453 patients, 140 nodules were benign and 119 were indeterminate. Among 259 patients, the final pathology results were divided into benign (149) and cancerous (110) groups, and the prevalence of malignancy was 38.9% in the benign group and 55.5% in the indeterminate group. Among the malignancies, follicular carcinoma and follicular variants of papillary carcinoma were observed in 83% of the cytologically benign group and 62.8% of the indeterminate group. Conclusion: Preoperative FNAB had high false-negative rates and low diagnostic accuracy in patients with thyroid nodules >4 cm without suspicious cytologic features; therefore, diagnostic surgery may be considered a treatment option.

Remote-access thyroidectomy with the da Vinci SP system: feasibility in a cadaveric model.

Background: This study aims to study the feasibility of a remote-access thyroidectomy through presternal and submental approaches with the da Vinci SP system. Methods: Bilateral thyroidectomies were performed in five cadaveric models. A single incision in the presternal area was used in two cadavers, and a submental facelift incision approach was used in three cadavers. Results: Performing remote-access thyroidectomy was completed with a presternal approach in one cadaver and with the submental approach in three cadavers. The required skin flap development was minimal, and the docking time for the SP system was quick for all procedures. Time to full exposure of the thyroid gland after skin incision was less than 30 min for the presternal approach and less than 27 min for the submental procedure. Completing total thyroidectomies took 83 min in the presternal approach and between 67 and 127 min in the submental access. No additional ports were required to expose the gland and complete the bilateral resection. Conclusions: Total thyroidectomy was feasible with the da Vinci SP system in single incision presternal and submental approaches comparing promisingly with other currently applied robotic methods. Further studies will be required to assess whether a presternal or submental thyroidectomy with the da Vinci SP system provides clinical benefits in real patients.

Effects of Deep Neuromuscular Block during Robot-Assisted Transaxillary Thyroidectomy: A Randomized Controlled Trial.

The occurrence of significant pain and paresthesia after robot-assisted transaxillary thyroidectomy has been reported, and some patients experience chronic symptoms even three months after surgery. This study scrutinized the effects of deep neuromuscular block during robot-assisted transaxillary thyroidectomy on postoperative pain and sensory changes. In this single-blinded, prospective, randomized, controlled trial, 88 patients who underwent robot-assisted transaxillary thyroidectomy were enrolled and randomly allocated to either the moderate or deep neuromuscular block groups. Study endpoints included postoperative pain, paresthesia, and sensory change after surgery. The linear mixed models for numeric rating scale pain scores in the chest, neck, and axilla all showed significant intergroup differences over time (p = 0.003 in chest; p = 0.001 in neck; p = 0.002 in axilla). In the post hoc analysis with Bonferroni correction, the pain scores of the chest, neck, and axilla were significantly lower in the deep neuromuscular block group on postoperative day one compared to the moderate neuromuscular block group (adjusted p < 0.001 in chest, neck, and axilla). This study demonstrated that deep neuromuscular block could reduce postoperative pain after robot-assisted transaxillary thyroidectomy. However, it could not demonstrate that deep neuromuscular block reduces paresthesia or hypoesthesia after the surgery.