Background: Phase angle (PA) has been proposed as a prognostic factor for evaluating postoperative outcomes across various types of surgery. In this study, we investigated whether preoperative PA measured in living liver donors is associated with postoperative recovery. Methods: Donors aged over 19 years, scheduled for elective purely laparoscopic donor hepatectomy, were included. Each donor underwent bioimpedance analysis(BIA), including PA, on the day before surgery (PA pre ) and the third postoperative day (PAPOD3 ) using the InBody S10 (InBody Co., Ltd, Seoul, Korea). Postoperativerecovery quality was assessed using the Korean version of the quality of recovery (QoR-15K). All donors completed the QoR-15K on POD3 and POD21 to evaluate their recovery following surgery and anesthesia. Results: The mean age of the participants was 38.7±13.2 years, and 24 maledonors (59%) were included. PAPOD3 significantly decreased compared to PA pre(5.42±0.97 vs. 5.99±0.76; mean difference: —0.57, p=0.004). The extracellular water ratio (ECWR) on POD3 increased compared to preoperative levels (0.391±0.011 vs.0.378±0.007; mean difference: 0.013, p<0.001). However, skeletal muscle massindex (SMI) did not significantly change over time (SMI pre : 7.5±1.1; SMI POD3 : 8.0±1.2;p=0.67). Neither PA pre nor ECWR pre was associated with QoR-15K scores on POD3.However, SMI pre was significantly associated with QoR-15K on POD3, but not onPOD21. In the logistic regression model, preoperative BIA variables were not associated with in-hospital complications. Conclusion While PA pre was not associated with postoperative recovery or com-plications, a higher SMI was identified as a significant predictor of better recovery, suggesting its potential use as a screening tool in living liver donors.

The GlideScope® videolaryngoscope (GVL) is widely used in patients with difficult airways and provides a good glottic view. However, the acute angle of the blade can make insertion and advancement of an endotracheal tube (ETT) more difficult than direct laryngoscopy, and the use of a stylet is recommended. This randomized controlled trial compared Parker Flex-It™ stylet (PFS) with GlideRite® rigid stylet (GRS) to facilitate intubation with the GVL in simulated difficult intubations. Methods: Fifty-four patients were randomly allocated to undergo GVL intubation using either GRS (GRS group) or PFS (PFS group). The total intubation time (TIT), 100-mm visual analog scale (VAS) for ease of intubation, success rate at the first attempt, use of laryngeal manipulation, tube advancement rate by assistant, and complications were recorded. Results: There was no significant difference between the GRS and PFS groups regarding TIT (50.3 ± 12.0 s in the GRS group and 57.8 ± 18.8 s in the PFS group, P = 0.108). However, intubation was more difficult in the PFS group than in the GRS group according to VAS score (P = 0.011). Cases in which the ETT was advanced from the stylet by an assistant, were more frequent in the GRS group than in the PFS group (P = 0.002). The overall incidence of possible complications was not significantly different. Conclusions: In patients with a simulated difficult airway, there was no difference in TIT using either the PFS or GRS. However, endotracheal intubation with PFS is more difficult to perform than GRS.

Background: Long thoracic nerve (LTN) neuropathy occasionally occurs in young people who engage in various sports. It may have a traumatic or non-traumatic etiology. The landmark manifestation of LTN neuropathy is scapular winging; however, it can also occur without scapular winging and specific magnetic resonance imaging findings.Case: An 18-year-old male complained of right-sided lateral chest pain for 7 months. He was treated with medication, trigger point injection, and physical therapy but showed no improvement. Electromyelogram findings suggested LTN neuropathy in the right lateral chest. We performed a serratus anterior (SA) plane block with ultrasound (US)-guided hydrodissection and achieved pain relief. Conclusions We report the successful treatment of LTN neuropathy with an SA plane block and US-guided hydrodissection.