2025/10/17 更新

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写真a

ゴトウ タカヒサ
後藤 隆久
Takahisa Goto
所属
医学研究科 医科学専攻 麻酔科学 主任教授
医学部 医学科
職名
主任教授
外部リンク

学位

  • 医学博士 ( 東京大学 )

研究キーワード

  • perioperative medicine

  • anesthesiology

  • medical economics

  • intensive care medicine

  • 周術期管理学

  • 麻酔学

  • 医療経済学

  • 集中治療医学

  • 高等教育論

研究分野

  • ライフサイエンス / 医療管理学、医療系社会学

  • ライフサイエンス / 麻酔科学

  • ライフサイエンス / 救急医学

学歴

  • 東京大学   医学部   医学科

    1981年4月 - 1987年3月

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    国名: 日本国

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  • 東京大学   教育学研究科   大学経営・政策コース

    2021年4月

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    国名: 日本国

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所属学協会

  • International Association for the Study of Pain(IASP)

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  • 日本集中治療医学会

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  • Society for Neuroscience

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  • 日本神経科学学会

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  • 日本麻酔学会

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  • アメリカ麻酔学会(American Society of Anesthesologists(ASA)

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▼全件表示

論文

  • Association Between Anxiety and Depressive Symptoms During Prehospitalization Waiting Period and Quality of Recovery at Postoperative Day 3 in Perioperative Cancer Patients. 国際誌

    Kazue Araya, Mayu Fukuda, Takahiro Mihara, Takahisa Goto, Tomoko Akase

    Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses   37 ( 5 )   654 - 661   2022年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Perioperative depressive symptoms are associated with poor postoperative quality of life (QOL), leading to prolonged hospital stays, and delayed return to society. Previous studies show that physical and mental states change on the third day after surgery, and there is a correlation between quality of recovery (QoR) on this day and QOL at 3 months after surgery. QoR after surgery is an important indicator of postoperative QOL. However, there are no reports on the association between depressive symptoms, and postoperative QoR. Therefore, the study purpose was to clarify the relationship between depressive symptoms in perioperative cancer patients during the prehospitalization waiting period, and QoR on the third postoperative day. DESIGN: This was a prospective cohort study. METHODS: We examined whether depressive symptoms during the prehospitalization waiting period were related to QoR on day 3 after surgery in perioperative cancer patients. Subjects were patients with primary tumors who underwent surgery under general anesthesia. Subjects completed self-administered questionnaires during the prehospitalization waiting period and on postoperative day 3. The presence and/or absence of depressive symptoms was measured using the Hospital Anxiety and Depression Scale. Subjects were divided into two groups: depressive symptoms or non-depressive symptoms. Postoperative QoR was determined using the QoR-40 questionnaire and we calculated the rate of change in QoR-40 global and dimension scores from preoperation to postoperation. FINDINGS: 231 individuals met the inclusion criteria and agreed to participate in the study. Of these, 173 were included in the analysis. Only the rate of change in emotional state differed significantly between groups (P = .022). Both global and dimension QoR-40 scores were lower in the depressive symptoms group than in the non-depressive symptoms group. CONCLUSIONS: These findings demonstrate the need to provide both psychological and physical support continuously from the preoperative to early postoperative stage for cancer patients with depressive symptoms in the prehospitalization waiting period.

    DOI: 10.1016/j.jopan.2021.11.007

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  • アメリカの大学の合併

    黒田有紀, 後藤隆久, 常木善之, 長井総之介, 中村智治, 両角亜希子

    東京大学大学院教育学研究科紀要   61   485 - 509   2022年4月

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    記述言語:日本語   掲載種別:研究論文(大学,研究機関等紀要)  

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  • 麻酔科術前外来における周麻酔期看護師による麻酔同意書取得補助業務

    井出 悠紀子, 長嶺 祐介, 大山 亜希子, 田中 菜奈子, 水野 祐介, 宮下 徹也, 後藤 隆久

    麻酔   70 ( 12 )   1373 - 1377   2021年12月

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    記述言語:日本語   出版者・発行元:克誠堂出版(株)  

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  • 麻酔科術前外来における周麻酔期看護師による麻酔同意書取得補助業務

    井出 悠紀子, 長嶺 祐介, 大山 亜希子, 田中 菜奈子, 水野 祐介, 宮下 徹也, 後藤 隆久

    麻酔   70 ( 12 )   1373 - 1377   2021年12月

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    記述言語:日本語   出版者・発行元:克誠堂出版(株)  

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  • 周麻酔期看護師の新規院内制度導入に伴う整備や倫理的手続き

    井出 悠紀子, 長嶺 祐介, 藤本 寛子, 宮下 徹也, 水野 祐介, 後藤 隆久

    麻酔   70 ( 4 )   431 - 437   2021年4月

  • 周術期医療のさらなる安全性と「協調性」を拓く・周麻酔期看護師の挑戦

    井出 悠紀子, 長嶺 祐介, 後藤 隆久

    日本手術医学会誌   42 ( 1 )   96 - 101   2021年3月

  • 周麻酔期看護師が行う気管挿管の合併症についての報告

    井出 悠紀子, 長嶺 祐介, 馬場 靖子, 後藤 隆久

    臨床麻酔   44 ( 11 )   1481 - 1483   2020年11月

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    記述言語:日本語   出版者・発行元:真興交易(株)医書出版部  

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  • Introduction of evolving roles of Japanese perianesthesia nurses.

    Yukiko Ide, Yuki Umeno, Nanako Tanaka, Yusuke Nagamine, Takahisa Goto, Susan P McMullan

    Journal of anesthesia   34 ( 5 )   719 - 722   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The aim of this special article is to introduce Perianesthesia Nurses (PANs) who play an essential role in assisting anesthesiologists to ensure the safety of patients undergoing anesthesia and to improve the quality of anesthetic care. In Japan, there is no national license for nurse anesthesia providers. Therefore, most of the tasks related to anesthesia are performed by the anesthesiologists. Due to the size and complexity of the aging population, higher quality perioperative care is needed. In search of a solution, PANs were introduced to improve anesthetic care in Japan, enabling anesthesiologists to delegate some of their tasks to PANs who work within the scope of registered nurse's policies. They are a new type of anesthesia care provider in Japan, and different from Certified Registered Nurse Anesthetists in the United States. Currently, six schools provide 2-year master's degree perianesthesia nursing programs, and graduates are now providing anesthetic care both inside and outside of the operating room under the direct supervision of anesthesiologists. PANs not only assist anesthesiologists and help to reduce anesthesiologists' workload, but also contribute to the expansion of anesthesia services. They ensure patient safety and improve the quality of patient care before, during, and after the patient undergoing anesthesia.

    DOI: 10.1007/s00540-020-02826-3

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  • 横浜市立大学附属病院における周麻酔期看護師の業務の実態および患者サービス向上への貢献

    井出 悠紀子, 大山 亜希子, 田中 菜奈子, 長嶺 祐介, 藤本 寛子, 岡村 健太, 宮下 徹也, 水野 祐介, 後藤 隆久

    日本手術医学会誌   41 ( 2 )   182 - 186   2020年6月

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    記述言語:日本語   出版者・発行元:日本手術医学会  

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  • 横浜市立大学大学院周麻酔期看護学課程における手術麻酔実習の報告

    大山 亜希子, 井出 悠紀子, 長嶺 祐介, 藤本 寛子, 宮下 徹也, 水野 祐介, 赤瀬 智子, 後藤 隆久

    日本手術医学会誌   41 ( 2 )   175 - 181   2020年6月

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    記述言語:日本語   出版者・発行元:日本手術医学会  

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  • 周麻酔期看護師が施行した全身麻酔の患者循環動態は、麻酔科医が施行した場合とで異なるのか? 循環動態から考察する周麻酔期看護師の麻酔の質

    佐藤 仁, 安部 猛, 大須賀 明里, 川上 裕理, 後藤 隆久

    医療の質・安全学会誌   14 ( Suppl. )   478 - 478   2019年11月

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    記述言語:日本語   出版者・発行元:(一社)医療の質・安全学会  

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  • Creatinine production rate is an integrative indicator to monitor muscle status in critically ill patients

    Natsuhiro Yamamoto, Kentaro Tojo, Takahiro Mihara, Rae Maeda, Yuki Sugiura, Takahisa Goto

    Critical Care   29 ( 1 )   2025年1月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media LLC  

    DOI: 10.1186/s13054-024-05222-5

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    その他リンク: https://link.springer.com/article/10.1186/s13054-024-05222-5/fulltext.html

  • Ability of pulse oximetry-derived indices to predict hypotension after spinal anesthesia for cesarean delivery: A systematic review and meta-analysis. 国際誌

    Yuriko Kondo, Eishin Nakamura, Hisashi Noma, Sayuri Shimizu, Takahisa Goto, Takahiro Mihara

    PloS one   20 ( 1 )   e0316715   2025年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Cesarean deliveries are often performed under spinal anesthesia because of the reduced risk of complications compared with that of general anesthesia. However, hypotension frequently occurs and adversely affects both the mother and fetus. Indices, such as the perfusion index (PI) and pleth variability index (PVI), which are derived from pulse oximetry have been used in numerous studies to predict hypotension after spinal anesthesia. However, their predictive abilities remain controversial. This study aimed to investigate the ability of PI and PVI, measured before the initiation of spinal anesthesia, to predict hypotension after spinal anesthesia in patients undergoing cesarean deliveries. To this end, we conducted a systematic review and meta-analysis. We searched MEDLINE, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, ClinicalTrials.gov, European Union Clinical Trials Register, World Health Organization International Clinical Trials Registry Platform, and University Hospital Medical Information Network Clinical Trials Registry databases from inception until June 15, 2023. We included retrospective and prospective observational studies and randomized controlled trials that assessed the ability of PI and PVI, measured before the initiation of spinal anesthesia, to predict hypotension after spinal anesthesia during cesarean delivery. We did not restrict our search to specific languages. Of the 19 studies, involving 1437 patients, 17 assessed the PI in 1,311 patients, and 5 assessed the PVI in 344 patients. The summary sensitivity and specificity of the PI were 0.75 (95% confidence interval [CI]: 0.69-0.80) and 0.64 (95%CI: 0.48-0.77), respectively, while those of the PVI were 0.63 (95%CI: 0.47-0.76) and 0.76 (95%CI: 0.64-0.84), respectively. The area under the summary receiver operating characteristic curve was approximately 0.75 for both indexes. Baseline PI and PVI have a moderate predictive ability for hypotension after spinal anesthesia in patients undergoing cesarean delivery.

    DOI: 10.1371/journal.pone.0316715

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  • Immune-related adverse events in cancer patients referred to the palliative care team of a tertiary care center: a retrospective observational study. 国際誌

    Ryota Yanaizumi, Yusuke Nagamine, Shinsuke Harada, Takahisa Goto

    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer   32 ( 12 )   793 - 793   2024年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: The application of immune checkpoint inhibitors (ICIs) can cause multi-organ adverse events, namely immune-related adverse events (irAEs) in patients with cancer. This study aimed to characterize the epidemiological information on irAEs in patients with cancer referred to the palliative care team (PCT). METHODS: The medical records of cancer patients with a history of ICI therapy referred to the PCT at a tertiary care center between January 2017 and July 2022 were retrospectively reviewed in this single-center, observational study. RESULTS: The median age of the 140 patients was 68 years, and lung (39.3%) being the most common primary site. We observed irAEs in 46 patients (32.9%), and hypothyroidism was the most common irAE. For irAEs graded ≥ 3 in 21 patients, pneumonitis was the most common adverse event. As for strategies for management with irAEs, seventeen patients were treated with systemic steroids. irAEs ( +) had a significantly lower Performance Status at the start of ICI, a higher total number of ICI doses, and longer duration from start of ICI to date of death than irAEs (-). CONCLUSIONS: Among 140 cancer patients with a history of ICIs therapy consulted to the PCT, the prevalence of irAEs was 32.9%, and 21 patients (15.0%) developed irAEs with grade ≥ 3. As the use of ICI is expected to increase in the future, it is important for palliative care physicians to increase their awareness of the management of irAEs and collaborate with oncologists from an early stage.

    DOI: 10.1007/s00520-024-09012-1

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  • 心臓血管外科術後の急性腎障害発生予測モデルの構築

    横山 暢幸, 高木 俊介, 三角 俊裕, 出井 真史, 柏木 静, 横瀬 真志, 中村 謙介, 後藤 隆久

    日本集中治療医学会雑誌   31 ( Suppl.1 )   S591 - S591   2024年9月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • Hypotension after general anaesthesia induction using remimazolam or propofol in geriatric patients undergoing sevoflurane anaesthesia with remifentanil: a single-centre, double-blind, randomised controlled trial. 国際誌

    Ryuki Takaki, Masashi Yokose, Takahiro Mihara, Yusuke Saigusa, Hiroyuki Tanaka, Natsuhiro Yamamoto, Kenichi Masui, Takahisa Goto

    British journal of anaesthesia   2024年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The occurrence of hypotension after induction of general anaesthesia is common in geriatric patients, and should be prevented to minimise perioperative complications. Compared with propofol, remimazolam potentially has a lower incidence of hypotension. This study aimed to compare the incidence of hypotension after general anaesthesia induction with remimazolam or propofol in geriatric patients. METHODS: This single-centre, double-blind, randomised trial enrolled 90 patients aged ≥80 yr who received general anaesthesia for scheduled surgery. Patients were randomised to receive remimazolam (12 mg kg-1 h-1) or propofol (0.025 mg kg-1 s-1) for anaesthesia induction, with remifentanil and sevoflurane. The presence or absence of hypertension on the ward served as the stratification factor. The incidence of hypotension after the induction of general anaesthesia, defined as a noninvasive mean arterial pressure of <65 mm Hg measured every minute from initiation of drug administration to 3 min after tracheal intubation, was the primary outcome. Subgroup analysis was performed for the primary outcome using preoperative ward hypertension, clinical frailty scale, Charlson Comorbidity Index, and age. RESULTS: Three subjects were excluded before drug administration, and 87 subjects were included in the analysis. The incidence of hypotension was 72.1% (31/43) and 72.7% (32/44) with remimazolam or propofol, respectively. No statistically significant differences (adjusted odds ratio, 0.96; 95% confidence interval, 0.37-2.46; P=0.93) were observed between groups. Subgroup analysis revealed no significant differences between groups. CONCLUSIONS: Compared with propofol, remimazolam did not reduce the incidence of hypotension after general anaesthesia induction in patients aged ≥80 yr. CLINICAL TRIAL REGISTRATION: UMIN000042587.

    DOI: 10.1016/j.bja.2024.04.013

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  • アニメーション動画を用いた麻酔説明が無痛分娩前の妊婦の不安に与える影響について

    堺 結有, 松田 優子, 長嶺 祐介, 平本 綾子, 山本 さおり, 片倉 友美, 新井 悠介, 日暮 亜矢, 若山 洋美, 赤松 千加, 岩田 亜貴子, 倉澤 健太郎, 後藤 隆久

    麻酔   73 ( 4 )   278 - 285   2024年4月

  • Hypoglycemia in Terminally Ill Patients with Cancer with a History of Diabetes Mellitus Admitted to a General Ward: A Retrospective Observational Study. 国際誌

    Ryota Yanaizumi, Yusuke Nagamine, Shinsuke Harada, Takahisa Goto

    Palliative medicine reports   5 ( 1 )   373 - 380   2024年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Poor glycemic control may be a risk factor for hypoglycemia in terminally ill patients with cancer with a history of diabetes mellitus (DM). However, no guidelines have been established for achieving glycemic control in this patient population, and epidemiological information remains lacking. OBJECTIVES: We aimed to investigate the prevalence of hypoglycemic episodes and provide epidemiological information on hypoglycemia in terminally ill patients with cancer with a history of DM admitted to a general ward. DESIGN: This was a single-center, retrospective, observational study. SETTING/SUBJECTS: This study enrolled terminally ill patients with cancer with a history of DM, receiving palliative care at a hospital in Japan between January 2017 and July 2022. MEASUREMENTS: Data extracted from the patients' medical records were age, sex, body mass index, primary cancer, liver metastases, dialysis status, Eastern Cooperative Oncology Group performance status score, type and duration of DM, HbA1c level, and use of diabetes medications (antihyperglycemic agents and types and insulin) at the time of initial visit within 180 days of death. RESULTS: Among the 104 patients included in the analysis, hypoglycemic episodes occurred in 36 patients (34.6%). The total number of hypoglycemic episodes was 132, and the median number of hypoglycemic episodes for each patient during hospitalization was 2.5 (interquartile range, 1-6). CONCLUSIONS: The prevalence of hypoglycemia in terminally ill patients with cancer with a history of DM who were admitted to a Japanese general ward was 34.6%. Further studies are needed to determine the frequency of hypoglycemia because of overtreatment in this patient population.

    DOI: 10.1089/pmr.2024.0008

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  • Creatinine Reduction Ratio Is a Prognostic Factor for Acute Kidney Injury following Cardiac Surgery with Cardiopulmonary Bypass: A Single-Center Retrospective Cohort Study. 国際誌

    Akiko Anzai, Shunsuke Takaki, Nobuyuki Yokoyama, Shizuka Kashiwagi, Masashi Yokose, Takahisa Goto

    Journal of clinical medicine   13 ( 1 )   2023年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Acute kidney injury (AKI) after cardiac surgery is a common complication that can lead to death. We previously reported that the creatinine reduction ratio (CRR) serves as a useful prognostic factor for AKI. The primary objective of this study was to determine the predictors of AKI after surgery. The secondary objective was to determine the reliability of the CRR for short- and long-term outcomes. We retrospectively collected information about cardiac surgery patients who underwent cardiopulmonary bypass. Patients were divided into AKI and non-AKI groups based on the AKIN and RIFLE criteria. We analyzed the two groups regarding the preoperative patient data and operative information. The CRR was calculated as follows: (preoperative creatinine-postoperative creatinine)/preoperative creatinine. The prognostic factors of AKI-CS were surgery time, CPB time, aorta clamp time, platelet transfusion, and CRR < 20%. In the multivariate logistical analysis, CRR was an independent predictor of AKI (adjusted odds ratio: 0.90 [0.87-0.93], p < 0.001). However, there were no significant differences in CRR in terms of the rate of new onset chronic kidney disease (CKD). After cardiac surgery with cardiopulmonary bypass, CRR has good diagnostic power for predicting perioperative AKI. However, we cannot use it as a prognostic factor over a long-term period.

    DOI: 10.3390/jcm13010009

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  • 尿路感染による敗血症性ショックに,心筋虚血による二次性の心原性ショックを合併した1症例

    酒井 洋平, 長嶺 祐介, 出井 真史, 横山 暢幸, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    麻酔   72 ( 12 )   1145 - 1148   2023年12月

  • Role of protein kinase D1 in vasoconstriction and haemodynamics in rats. 国際誌

    Yoh Sugawara, Yusuke Mizuno, Shinya Oku, Yuri Sawada, Takahisa Goto

    Microvascular research   104627 - 104627   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIMS: Protein kinase D (PKD), once considered an effector of protein kinase C (PKC), now plays many pathophysiological roles in various tissues. However, little is known about role of PKD in vascular function. We investigated the role of PKD in contraction of rat aorta and human aortic smooth muscle cells (HASMCs) and in haemodynamics in rats. METHODS AND RESULTS: Isometric tension of rat aortic was measured to examine norepinephrine-induced contraction in the presence of PKD, PKC and Rho-kinase inhibitors. Phosphorylation of PKD1, myosin targeting subunit-1 (MYPT1), myosin light chain (MLC), CPI-17 and heat-shock protein 27 (HSP27), and actin polymerization were measured in the aorta. Phosphorylation of MYPT1 and MLC was also measured in HASMCs knocked down with specific siRNAs of PKD 1, 2 and 3. Intracellular calcium concentrations and cell shortening were measured in HASMCs. Norepinephrine-induced aortic contraction was accompanied by increased phosphorylation of PKD1, MYPT1 and MLC and actin polymerization, all of which were attenuated with PKD inhibitor CRT0066101. PKD1 phosphorylation was not inhibited by PKC inhibitor, chelerythrine or Rho kinase inhibitor, fasudil. In HASMCs, the phosphorylation of MYPT1 and MLC was attenuated by PKD1, but not PKD2, 3 knockdown. In HASMCs, CRT0066101 inhibited norepinephrine-induced cell shortening without affecting calcium concentration. Administration of CRT0066101 decreased systemic vascular resistance and blood pressure without affecting cardiac output in rats. CONCLUSIONS: PKD1 may play roles in aorta contraction and haemodynamics via phosphorylation of MYPT1 and actin polymerization in a calcium-independent manner.

    DOI: 10.1016/j.mvr.2023.104627

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  • Postgraduate Developments Among Perianesthesia-Trained Nursing Graduates in Japan: A Cross-Sectional Survey. 国際誌

    Yukiko Ide, Yusuke Nagamine, Gaku Inagawa, Takahisa Goto

    Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To elucidate the postgraduation situation of those who have completed a perianesthesia nurse (PAN) educational course offered in master's degree programs in Japan. DESIGN: This cross-sectional study used an anonymous self-administered questionnaire. METHODS: Of the 42 individuals who completed a PAN educational course offered in master's degree programs in Japan by March 2021, 41 were targeted, excluding the author of this study. The questionnaire was distributed by mail between November 20, 2021, and January 14, 2022, and the participants were asked to return the completed questionnaire by mail. Those working as PANs were asked about their work content, work satisfaction, and thoughts on their prospects in the perianesthesia nursing field. Those not working as a PAN were asked about their future intentions to do so. FINDINGS: The response rate was 95.1% (39/41). PANs are involved in various perianesthesia tasks, and there were no respondents who answered "No" to the question of whether they were glad to have become a PAN. However, of those working as PANs, only 16 (53.3%) indicated that they would like to continue working in that role. Few respondents (n = 3; 10.0%) considered future PAN prospects to be "good," while eight (26.7%) respondents answered "poor," and many (n = 19; 63.3%) stated "neither." CONCLUSIONS: Under the current situation, PANs in Japan do not necessarily have a positive outlook for the future, the causes for which must be analyzed to make the necessary improvements.

    DOI: 10.1016/j.jopan.2023.08.001

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  • Effect of remote ischemic preconditioning on lung function after surgery under general anesthesia: a systematic review and meta-analysis. 国際誌

    Shizuka Kashiwagi, Takahiro Mihara, Ayako Yokoi, Chisaki Yokoyama, Daisuke Nakajima, Takahisa Goto

    Scientific reports   13 ( 1 )   17720 - 17720   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Remote ischemic preconditioning (RIPC) protects organs from ischemia-reperfusion injury. Recent trials showed that RIPC improved gas exchange in patients undergoing lung or cardiac surgery. We performed a systematic search to identify randomized controlled trials involving RIPC in surgery under general anesthesia. The primary outcome was the PaO2/FIO2 (P/F) ratio at 24 h after surgery. Secondary outcomes were A-a DO2, the respiratory index, duration of postoperative mechanical ventilation (MV), incidence of acute respiratory distress syndrome (ARDS), and serum cytokine levels. The analyses included 71 trials comprising 7854 patients. Patients with RIPC showed higher P/F ratio than controls (mean difference [MD] 36.6, 95% confidence interval (CI) 12.8 to 60.4, I2 = 69%). The cause of heterogeneity was not identified by the subgroup analysis. Similarly, A-a DO2 (MD 15.2, 95% CI - 29.7 to - 0.6, I2 = 87%) and respiratory index (MD - 0.17, 95% CI - 0.34 to - 0.01, I2 = 94%) were lower in the RIPC group. Additionally, the RIPC group was weaned from MV earlier (MD - 0.9 h, 95% CI - 1.4 to - 0.4, I2 = 78%). Furthermore, the incidence of ARDS was lower in the RIPC group (relative risk 0.73, 95% CI 0.60 to 0.89, I2 = 0%). Serum TNFα was lower in the RIPC group (SMD - 0.6, 95%CI - 1.0 to - 0.3 I2 = 87%). No significant difference was observed in interleukin-6, 8 and 10. Our meta-analysis suggested that RIPC improved oxygenation after surgery under general anesthesia.Clinical trial number: This study protocol was registered in the University Hospital Medical Information Network (registration number: UMIN000030918), https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000035305.

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  • Measurement accuracy of a microwave doppler sensor beneath the mattress as a continuous respiratory rate monitor: a method comparison study. 国際誌

    Hiroyuki Tanaka, Masashi Yokose, Shunsuke Takaki, Takahiro Mihara, Yusuke Saigusa, Takahisa Goto

    Journal of clinical monitoring and computing   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Non-contact continuous respiratory rate monitoring is preferred for early detection of patient deterioration. However, this technique is under development; a gold standard respiratory monitor has not been established. Therefore, this prospective observational method comparison study aimed to compare the measurement accuracy of a non-contact continuous respiratory rate monitor, a microwave Doppler sensor positioned beneath the mattress, with that of other monitors. METHODS: The respiratory rate of intensive care unit patients was simultaneously measured using a microwave Doppler sensor, capnography, thoracic impedance pneumography, and a piezoelectric sensor beneath the mattress. Bias and 95% limits of agreement between the respiratory rate measured using capnography (standard reference) and that measured using the other three methods were calculated using Bland-Altman analysis for repeated measures. Clarke error grid (CEG) analysis evaluated the sensor's ability to assist in correct clinical decision-making. RESULTS: Eighteen participants were included, and 2,307 data points were analyzed. The bias values (95% limits of agreement) of the microwave Doppler sensor, thoracic impedance pneumography, and piezoelectric sensor were 0.2 (- 4.8 to 5.2), 1.5 (- 4.4 to 7.4), and 0.4 (- 4.0 to 4.8) breaths per minute, respectively. Clinical decisions evaluated using CEG analyses were correct 98.1% of the time for the microwave Doppler sensor, which was similar to the performance of the other devices. CONCLUSION: The microwave Doppler sensor had a small bias but relatively low precision, similar to other devices. In CEG analyses, the risk of each monitor leading to inadequate clinical decision-making was low. TRIAL REGISTRATION NUMBER: UMIN000038900, February 1, 2020.

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  • Clinical features and prognosis of toxic epidermal necrolysis requiring intensive care: A retrospective descriptive single-center study 査読

    Yohei Sakai, Yusuke Nagamine, Masashi Yokose, Nobuyuki Yokoyama, Tasuku Yoshida, Shizuka Kashiwagi, Shunsuke Takaki, Takahisa Goto

    Burns Open   2023年10月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.burnso.2023.09.001

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  • Association between diaphragmatic dysfunction after adult cardiovascular surgery and prognosis of mechanical ventilation: a retrospective cohort study. 国際誌

    Reimi Inoue, Yusuke Nagamine, Masahide Ohtsuka, Takahisa Goto

    Journal of intensive care   11 ( 1 )   39 - 39   2023年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Diaphragmatic dysfunction often occurs after adult cardiovascular surgery. The prognostic effect of diaphragmatic dysfunction on ventilatory management in patients after cardiovascular surgery is unknown. This study aimed to investigate the association between diaphragmatic dysfunction and prognosis of ventilatory management in adult postoperative cardiovascular surgery patients. METHODS: This study was a single-center retrospective cohort study conducted at a tertiary care university hospital. This study included adult patients admitted to the intensive care unit under tracheal intubation after cardiovascular surgery. Spontaneous breathing trial was performed, and bilateral diaphragmatic motion was assessed using ultrasonography; diaphragmatic dysfunction was classified as normal, incomplete dysfunction, or complete dysfunction. The primary outcome was weaning off in mechanical ventilation. The duration of mechanical ventilation was defined as duration from the date of ICU admission to the date of weaning off in mechanical ventilation. The secondary outcomes were reintubation, death from all causes, improvement of diaphragm position assessed by chest radiographs. The subdistribution hazard ratio or hazard ratio (HR) with 95% confidence of intervals (CIs) were estimated by Fine-Gray models or Cox proportional hazard models adjusted for potential confounders. RESULTS: Of 153 patients analyzed, 49 patients (32.0%) had diaphragmatic dysfunction. Diaphragmatic dysfunction consisted of incomplete dysfunction in 38 patients and complete dysfunction in 11 patients. Diaphragmatic dysfunction groups had longer duration of mechanical ventilation (68 h [interquartile range (IQR) 39-114] vs 23 h [15-67], adjusted subdistribution HR 0.63, 95% CIs 0.43-0.92). There was a higher rate of reintubation (12.2% vs 2.9%, univariate logistic regression analysis p = 0.034, unadjusted odds ratio = 4.70, 95% CIs 1.12-19.65), and a tendency to have higher death from all causes in the diaphragmatic dysfunction group during follow-up period (maximum 6.5 years) (18.4% vs 9.6%, adjusted HR 1.64, 95% CIs 0.59-4.53). The time to improvement of diaphragm position on chest radiograph was significantly longer in the diaphragmatic dysfunction group (14 days [IQR 6-29] vs 5 days [IQR 2-10], adjusted subdistribution HR 0.54, 95% CIs 0.38-0.77). CONCLUSIONS: Diaphragmatic dysfunction after adult cardiovascular surgery was significantly associated with longer duration of mechanical ventilation and higher reintubation.

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  • セボフルランの位相振幅カップリング増強効果を用いたてんかん原性領域の局在化

    園田 真樹, 和田 圭伊子, Firestone Ethan, 坂倉 和樹, 黒田 直生人, 高山 裕太郎, 飯島 圭哉, 岩崎 真樹, 水原 敬洋, 山本 哲哉, 後藤 隆久, 浅野 英司, 宮崎 智之

    てんかん研究   41 ( 2 )   413 - 413   2023年9月

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    記述言語:日本語   出版者・発行元:(一社)日本てんかん学会  

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  • Incidence of perioperative hypotension in patients undergoing transurethral resection of bladder tumor after oral 5-aminolevulinic acid administration: a retrospective multicenter cohort study.

    Yuriko Kondo, Yusuke Nagamine, Nanako Yoshikawa, Noriyuki Echigo, Tatsuya Kida, Masakazu Sumitomo, Megumi Yoshida, Gaku Inagawa, Takahisa Goto

    Journal of anesthesia   2023年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Tumors can be visualized using 5-Aminolevulinic acid hydrochloride (5-ALA) during transurethral resection of bladder tumors (TURBT). Hypotension is an adverse effect of 5-ALA; however, its incidence and morbidity rates are unknown. This study aimed to describe the incidence of perioperative hypotension and identify risk factors for hypotension among patients after 5-ALA administration in TURBT. METHODS: This retrospective multicenter cohort study was conducted at three general hospitals in Japan. Adult patients who underwent elective TURBT after 5-ALA administration between April 2018 and August 2020 were included. The primary outcome was the incidence of perioperative hypotension (mean blood pressure < 65 mmHg). The secondary outcomes were the use of vasoactive agents and adverse events, including urgent intensive care unit (ICU) admission. Multivariate logistic regression analysis was performed to investigate risk factors of the incidence of intraoperative hypotension. RESULTS: The median age of 261 patients was 73 years. General anesthesia was induced in 252 patients. The intraoperative hypotension was observed in 246 (94.3%) patients. Three patients (1.1%) were urgently admitted to the ICU for continued vasoactive agent use after surgery. All three patients had renal dysfunction. Multivariate logistic regression analysis revealed that general anesthesia was significantly associated with intraoperative hypotension (adjusted odds ratio, 17.94; 95% confidence interval, 3.21-100.81). CONCLUSION: The incidence of hypotension in patients undergoing TURBT after 5-ALA administration was 94.3%. The incidence of urgent ICU admission with prolonged hypotension was 1.1% in all patients with renal dysfunction. General anesthesia was significantly associated with intraoperative hypotension.

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  • Predictive ability of pulse oximetry-derived indices for hypotension after spinal anaesthesia for caesarean section: protocol for a systematic review and meta-analysis. 国際誌

    Yuriko Kondo, Takahiro Mihara, Eishin Nakamura, Hisashi Noma, Sayuri Shimizu, Takahisa Goto

    BMJ open   13 ( 6 )   e069309   2023年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: In general, caesarean sections are performed under spinal anaesthesia. Hypotension after spinal anaesthesia adversely affects both the mother and fetus. Although several studies have used pulse oximetry-derived indices, such as pulse perfusion index (PI) and Pleth variability index (PVI), to predict hypotension after spinal anaesthesia, the predictive ability of the PI and PVI remain controversial. METHODS AND ANALYSIS: We prepared this protocol following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. We will conduct searches of MEDLINE, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Clinicaltrial.gov, European Union Clinical Trials Register (EU-CTR), WHO International Clinical Trials Registry Platform (ICTRP) and University Hospital Medical Information Network Clinical Trials Registry (UMIN) from inception until 8 October 2022. We will include retrospective and prospective observational studies and randomised controlled trials that evaluated the predictive ability of PI and PVI for hypotension after spinal anaesthesia for caesarean section, published in any language. We will exclude case reports, case series and animal studies. Two authors will independently scan and select eligible studies and perform data extraction and assessment of risk of bias. We will estimate predictive ability of PI and PVI as indices of hypotension after spinal anaesthesia for caesarean section using the Reitsma-type bivariate random-effects synthesis model and the hierarchical summary receiver operating characteristic curve. We will assess the quality of evidence using the Grading of Recommendation Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION: Ethics approval is not required as the systematic review will use existing published data. The results will be submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42022362596.

    DOI: 10.1136/bmjopen-2022-069309

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  • Stomach position evaluated using computed tomography is related to successful post-pyloric enteral feeding tube placement in critically ill patients: a retrospective observational study. 国際誌

    Masashi Yokose, Shunsuke Takaki, Yusuke Saigusa, Takahiro Mihara, Yoshinobu Ishiwata, Shingo Kato, Keiichi Horie, Takahisa Goto

    Journal of intensive care   11 ( 1 )   25 - 25   2023年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Post-pyloric enteral feeding reduces respiratory complications and shortens the duration of mechanical ventilation. Blind placement of post-pyloric enteral feeding tubes (EFT) in patients with critical illnesses is often the first-line method because endoscopy or fluoroscopy cannot be easily performed at bedside; however, difficult placements regularly occur. We reported an association between the stomach position caudal to spinal level L1-L2, evaluated by abdominal radiographs after placement, and difficult placement; however, this method could not indicate difficulty before EFT placement. The aim of our study was to evaluate the association between stomach position, estimated using computed tomography (CT) images taken before the blind placement of the post-pyloric EFT, and the difficulty of EFT placement. METHODS: Data from patients aged ≥ 20 years who underwent post-pyloric EFT in our intensive care unit were obtained retrospectively. Logistic regression analysis was used to evaluate the association between successful initial EFT placement and explanatory variables, including stomach position estimated by CT. Two cut-off values were used: caudal to L1-L2 based on a previous study and the best cut-off value calculated by the receiver operating characteristic curve. Variable selection was performed backward stepwise using Akaike's Information Criterion. RESULTS: Of the total of 453 patients who were enrolled, the success rate of the initial EFT placement was 43.5%. The adjusted odds ratio for successful initial EFT placement of the stomach position caudal to L1-L2 was 0.61 (95% confidence interval: 0.41-1.07). Logistic regression analysis, including the stomach position caudal to L2-L3, calculated as the best cut-off value, indicated that stomach position was an independent factor for failure of initial EFT placement (adjusted odds ratio, 0.55; 95% confidence interval: 0.33-0.91). CONCLUSIONS: Stomach position evaluated using CT images was associated with successful initial post-pyloric EFT placement. The best cut-off value of the greater curvature of the stomach to predict the success or failure of the first attempt was spinal level L2-L3. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN000046986; February 28, 2022). https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000052151.

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  • Effects of melatonin on postoperative sleep quality: a systematic review, meta-analysis, and trial sequential analysis. 国際誌

    Akito Tsukinaga, Takahiro Mihara, Teppei Takeshima, Makoto Tomita, Takahisa Goto

    Canadian journal of anaesthesia = Journal canadien d'anesthesie   70 ( 5 )   901 - 914   2023年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Postoperative sleep disturbances are common. Although several studies have examined the effect of melatonin on postoperative sleep disturbances, the results have not reached any definitive conclusion. We sought to conduct a systematic review to compare the effects of melatonin and melatonin agonists on postoperative sleep quality with those of placebo or no treatment in adult patients who underwent surgery under general or regional anesthesia. METHODS: We searched MEDLINE, Cochrane Central Register of Controlled Trials, Embase, Web of Science, ClinicalTrials.gov, and the UMIN Clinical Trials Registry up to 18 April 2022. Randomized clinical trials examining the effects of melatonin or melatonin agonists in patients undergoing general or regional anesthesia with sedation for any surgery were eligible for inclusion. The primary outcome was sleep quality measured using a visual analog scale (VAS). The secondary outcomes were postoperative sleep duration, sleepiness, pain, opioid consumption, quality of recovery, and adverse events. A random-effects model was used to combine the results. We assessed study quality with the Cochrane Risk of Bias Tool version 2. We applied a trial sequential analysis to assess the precision of the combined results. RESULTS: Eight studies (516 participants) were analyzed for sleep quality. Of those, four studies used only a short duration of melatonin, either on the night before and the day of surgery or only on the day of surgery. A random-effects meta-analysis showed that melatonin did not improve sleep quality measured by VAS compared with placebo (mean difference, -0.75 mm; 95% confidence interval, -4.86 to 3.35), with low heterogeneity (I2, 5%). Trial sequential analysis revealed that the accrued information size (n = 516) reached the estimated required information size (n = 295). We downgraded the certainty of the evidence because of the high risk of bias. The effect on postoperative adverse events was comparable between the melatonin and control groups. CONCLUSION: Our results indicate that melatonin supplementation does not improve postoperative sleep quality measured with the VAS compared with placebo in adult patients (GRADE: moderate). STUDY REGISTRATION: PROSPERO (CRD42020180167); registered 27 October 2022.

    DOI: 10.1007/s12630-023-02442-1

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  • Long-Term Analgesic Efficacy of Neurolytic Splanchnic Nerve Block via the Transintervertebral Disc Approach to Retrocrural Space: A Multicenter Retrospective Study. 国際誌

    Ryota Yanaizumi, Yusuke Nagamine, Shinsuke Harada, Tomoko Kuramochi, Shuhei Ota, Yoichiro Abe, Masayuki Nakagawa, Kenya Kamijima, Maya Hayashi, Toshiharu Tazawa, Kenichi Ogawa, Takahisa Goto

    Pain and therapy   2023年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: The celiac plexus block is effective for treating intractable cancer pain and has been the focus of many studies. At our affiliated institution, fluoroscopy-guided splanchnic nerve block with a single needle via the transintervertebral disc approach was the first choice of treatment. The short-term efficacy of this technique has been reported, but the long-term efficacy is not clear. In the present study, we investigated the long-term analgesic efficacy of this technique. METHODS: This multicenter, retrospective, observational study reviewed the medical records of patients who underwent neurolytic splanchnic nerve block (NSNB) via the transintervertebral disc approach for intractable cancer pain at five tertiary hospitals in Japan from April 2005 to October 2020. The primary outcome was the long-term analgesic efficacy of a one-time NSNB via the transintervertebral disc approach. RESULTS: In total, 76 patients were included in the analysis. The median lowest numerical rating scale (NRS) score was 1 within 14 days. At 1, 2, 3, and 6 months after the nerve block, the median NRS score was also ≤ 2, while the median equivalent oral morphine dose did not show any clinically noticeable increase at those times. CONCLUSION: The long-term analgesic efficacy of NSNB via the transintervertebral disc approach in patients with intractable cancer pain has been demonstrated.

    DOI: 10.1007/s40122-023-00506-0

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  • Effets de la mélatonine sur la qualité du sommeil postopératoire : une revue systématique, méta-analyse et analyse séquentielle des études

    Akito Tsukinaga, Takahiro Mihara, Teppei Takeshima, Makoto Tomita, Takahisa Goto

    Canadian Journal of Anesthesia/Journal canadien d'anesthésie   2023年3月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media LLC  

    DOI: 10.1007/s12630-023-02442-1

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  • Venoarterial-extra corporeal membrane oxygenation-assisted parathyroidectomy for hypercalcemic crisis due to parathyroid carcinoma complicated by severe circulatory and respiratory failure: a case report. 国際誌

    Yuria Enomoto, Yuko Matsuda, Yusuke Nagamine, Takahisa Goto

    JA clinical reports   9 ( 1 )   14 - 14   2023年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Hypercalcemia crisis is a rare but severe form of hypercalcemia complicated by multiple organ failure. Hypercalcemia crisis due to hyperparathyroidism is commonly caused by a parathyroid tumor, which often requires surgical resection. However, there are no clear recommendations on when the surgery should be performed. CASE PRESENTATION: A 64-year-old female patient developed hyperparathyroidism due to a parathyroid tumor and hypercalcemic crisis, which was complicated by severe circulatory and respiratory failure refractory to medical therapy, and an emergent surgery was planned to resect the parathyroid tumor. To prevent intraoperative circulatory and respiratory collapse, venoarterial-extra corporeal membrane oxygenation (VA-ECMO) was introduced, resulting in a safe operation and anesthetic management. CONCLUSIONS: In patients with hypercalcemic crisis complicated by severe circulatory and respiratory failure, induction of prophylactic VA-ECMO was useful for safe anesthetic management. Surgical resection should be performed as soon as the diagnosis is made before VA-ECMO is required.

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  • 当施設におけるCOVID-19流行期の手術件数の推移と手術室運営

    藤本 寛子, 永田 桃子, 長嶺 祐介, 入江 友哉, 後藤 隆久

    臨床麻酔   47 ( 2 )   209 - 212   2023年2月

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    記述言語:日本語   出版者・発行元:(株)シービーアール  

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  • 当施設におけるCOVID-19流行期の手術件数の推移と手術室運営

    藤本 寛子, 永田 桃子, 長嶺 祐介, 入江 友哉, 後藤 隆久

    臨床麻酔   47 ( 2 )   209 - 212   2023年2月

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  • Association Between Patient Satisfaction and Preoperative Task-shifting From Anesthesiologists to Perianesthesia Nurses: A Questionnaire Survey Study. 国際誌

    Akari Osuga, Takeru Abe, Hitoshi Sato, Takahisa Goto

    Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses   2023年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: We examined whether patients' satisfaction improved when patients' preoperative consultations were conducted with perianesthesia nurses (PANs) in collaboration with anesthesiologists, as compared with preoperative consultations conducted by anesthesiologists only. DESIGN: We conducted a study using questionnaires regarding outpatient satisfaction among patients who visited the perioperative management department of Yokohama City University Medical Center between July and December 2018. METHODS: There were 1,595 outpatients during the survey period. After exclusion criteria were applied, we analyzed 590 valid responses. FINDINGS: Regarding the level of understanding, 96.9% of the patients in the nurse-and-anesthesiologist group and 95.6% of the patients in the anesthesiologist-only group answered, "easy to understand," indicating no significant difference. A reduction in concerns, worries, and anxiety was reported by 86.3% of the patients in the nurse-and-anesthesiologist group and 70.4% in the anesthesiologist-only group, indicating a significant difference. Furthermore, 94.1% of the patients in the nurse-and-anesthesiologist group and 87.9% in the anesthesiologist-only group indicated patients' satisfaction with the overall evaluation, indicating another significant difference. A multiple logistic regression analysis was conducted to analyze the anxiety reduction and overall evaluation. We uncovered significant differences in PANs' examinations regarding anxiety reduction and overall evaluation. CONCLUSIONS: Collaboration between anesthesiologists and PANs might be associated with satisfaction and reduced anxiety in preoperative patients without adversely affecting patients' comprehension of anesthesia. Further research is necessary to verify the impacts of PANs' involvement in anesthesia patient care on intra and postoperative patient outcomes and on the cost and efficiency of anesthetic care.

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  • Association between Intraoperative Early Warning Score and Mortality and In-Hospital Stay in Lower Gastrointestinal Spontaneous Perforation. 国際誌

    Kazuya Takada, Yusuke Nagamine, Akira Ishii, Yan Shuo, Takumi Seike, Hanako Horikawa, Kentaro Matsumiya, Tetsuya Miyashita, Takahisa Goto

    Anesthesiology research and practice   2023   8910198 - 8910198   2023年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Early warning scores (EWSs) can be easily calculated from physiological indices; however, the extent to which intraoperative EWSs and the corresponding changes are associated with patient prognosis is unknown. In this study, we investigated whether EWS and the corresponding time-related changes are associated with patient outcomes during the anesthetic management of lower gastrointestinal perforation. METHODS: This was a single-center, retrospective cohort study conducted at a tertiary emergency care center. Adult patients who underwent surgery for spontaneous lower gastrointestinal perforations between September 1, 2012, and December 31, 2019, were included. The National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) were calculated based on the intraoperative physiological indices, and the associations with in-hospital death and length of hospital stay were investigated. RESULTS: A total of 101 patients were analyzed. The median age was 70 years, and there were 11 cases of in-hospital death (mortality rate: 10.9%). There was a significant association between the intraoperative maximum NEWS and in-hospital death (odds ratio (OR): 1.60, 95% confidence interval (CI): 1.10-2.32, p=0.013) and change from initial to maximum NEWS (OR: 1.60, 95% CI: 1.07-2.40, p=0.023) in the crude analysis. However, when adjustments were made for confounding factors, no statistically significant associations were found. Other intraoperative EWS values and changes were not significantly associated with the investigated outcomes. The preoperative sepsis-related organ failure assessment score and the intraoperative base excess value were significantly associated with in-hospital death. CONCLUSIONS: No clear association was observed between EWSs and corresponding changes and in-hospital death in cases of lower gastrointestinal perforation. The preoperative sepsis-related organ failure assessment score and intraoperative base excess value were significantly associated with in-hospital death.

    DOI: 10.1155/2023/8910198

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  • Effectiveness of acupuncture therapy for the prevention of emergence agitation in children: A systematic review and meta-analysis with trial sequential analysis. 国際誌

    Takahiro Mihara, Daisuke Nakajima, Toshiyuki Hijikata, Makoto Tomita, Takahisa Goto

    PloS one   18 ( 6 )   e0286790   2023年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    This study aimed to evaluate the effectiveness of acupuncture therapy in preventing emergence agitation (EA) in children. A systematic review and meta-analysis were conducted across multiple locations according to the articles searched. Seven databases, including trial registration sites, were searched. A total of six trials were included involving 489 patients; of them, 244 received acupuncture therapy. Randomized clinical trials (RCTs) evaluating the incidence of EA compared with placebo/sham or standard care in children were included. The primary outcome was the incidence of EA, as evaluated using a specific assessment tool. Data about the incidence rate of EA, heterogeneity, quality of trials and evidence, and adverse events were collected. Additionally, data about patient demographic characteristics, type of anesthesia, duration and onset of acupuncture therapy, EA and pain score, time taken for extubation, and post-anesthesia care unit length of stay were collected. The results indicated that the overall incidence of EA in the acupuncture therapy group and the control group was 23.4% and 39.5%, respectively, with no significant difference (risk ratio, 0.62; 95% confidence interval, 0.26-1.48; I2 = 63%). Subgroup analysis showed a significant difference in the overall incidence of EA in the acupuncture therapy and control groups according to surgery type (high-risk vs. low-risk surgery), suggesting that acupuncture therapy may be effective in reducing EA for patients undergoing high-risk surgery. The quality of evidence was downgraded to "very low" due to the study designs, inconsistency, and possible publication bias. In conclusion, this meta-analysis shows that the currently available RCTs are insufficient to determine the effectiveness of acupuncture therapy in preventing EA in children undergoing general anesthesia.

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  • Opioid withdrawal symptoms after neurolytic splanchnic nerve block in cancer patients. 国際誌

    Ryota Yanaizumi, Yusuke Nagamine, Shinsuke Harada, Tomoko Kuramochi, Shuhei Ota, Takahisa Goto

    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer   31 ( 1 )   25 - 25   2022年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Few reports on opioid withdrawal (OW) due to opioid tapering in cancer patients have been published. The incidence of and risk factors for OW after neurolytic splanchnic nerve block (NSNB) are unknown. This study aimed to elucidate the incidence of and risk factors for OW among cancer patients who could have reduced opioid doses after NSNB. METHODS: This was a multicenter, retrospective, observational study. We reviewed the medical charts of patients who underwent NSNB for intractable cancer pain at four tertiary hospitals in Yokohama City from April 2005 to October 2020. We included patients whose opioid dose was reduced by > 5 mg/day (equivalent oral morphine dose) within 14 days after NSNB. We classified the patients into two groups according to the presence or absence of OW symptoms and compared them. RESULTS: Of the 50 patients who underwent NSNB, 24 were included in the study. OW was observed in five (20.8%) patients. Pain and opioid use duration were significantly longer in OW patients than in non-OW patients (median pain duration 689 vs. 195 days; P < 0.043 and median opioid use duration 486 vs. 136 days; P < 0.030). The opioid tapering dose was significantly larger in patients with OW than in those without OW (median opioid tapering dose 75 vs. 40 mg; P < 0.046). CONCLUSIONS: OW was observed in 20.8% of the patients in the study. A longer pain and opioid use duration and a larger opioid tapering dose may predispose patients to OW.

    DOI: 10.1007/s00520-022-07528-y

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  • Efficacy and Safety of Neurolytic Splanchnic Nerve Block via Transintervertebral Disc Approach to Retrocrural Space: A Multicenter Retrospective Study. 国際誌

    Ryota Yanaizumi, Yusuke Nagamine, Shinsuke Harada, Tomoko Kuramochi, Shuhei Ota, Yoichiro Abe, Masayuki Nakagawa, Kenya Kamijima, Maya Hayashi, Toshiharu Tazawa, Kenichi Ogawa, Takahisa Goto

    Pain and therapy   11 ( 4 )   1359 - 1372   2022年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: Celiac plexus block is effective for treating intractable cancer pain and has been the focus of many studies. Several guiding techniques such as fluoroscopy, computed tomography, and endoscopy have been devised, and the target of the block has varied in previous studies as both the celiac plexus and splanchnic nerve, which is the main origin of the celiac plexus, have been targeted. At our affiliated institution, fluoroscopy-guided splanchnic nerve block with a single needle via transintervertebral disc approach is the first choice. However, there have been few reports on the use of this technique. This study investigated the efficacy and safety of this technique. METHODS: This multicenter retrospective observational study reviewed the medical records of patients who underwent neurolytic splanchnic nerve block (NSNB) via transintervertebral disc approach for intractable cancer pain at five tertiary hospitals in Japan from April 2005 to October 2020. The primary outcome was the clinical success ratio of NSNB, and the secondary outcome was the incidence ratio of NSNB-related adverse events. RESULTS: In total, 103 patients were included in the analysis. Of these, 77 patients met the definition of clinical success, with a ratio of 74.8%. The incidence ratio of NSNB-related adverse events was 40.8% (hypotension, 21.4%; alcohol intoxication, 13.6%; diarrhea, 11.7%; and vascular puncture, 3.9%; duplicates were present). All adverse events improved with observation and symptomatic treatment only. No patient had infection or serious adverse events such as organ or nerve damage. CONCLUSIONS: The clinical success ratio of this technique was 74.8%. Although the incidence of adverse events was 40.8%, all events were mild and no serious adverse events were observed. The findings demonstrate the efficacy and safety of our NSNB in patients with intractable cancer pain.

    DOI: 10.1007/s40122-022-00432-7

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  • 全国の大学院修士課程で行われる周麻酔期看護師の養成課程修了者に対するアンケート調査

    井出 悠紀子, 長嶺 祐介, 伊奈川 岳, 後藤 隆久

    日本臨床麻酔学会誌   42 ( 6 )   S182 - S182   2022年10月

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    記述言語:日本語   出版者・発行元:日本臨床麻酔学会  

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  • リンパ管静脈吻合術を受ける患者に対するSF-12による術前QOLの調査

    荒屋 和江, 長嶺 祐介, 水野 祐介, 後藤 隆久

    日本手術医学会誌   43 ( Suppl. )   159 - 159   2022年10月

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    記述言語:日本語   出版者・発行元:日本手術医学会  

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  • 人工心肺を使用した上大静脈内腫瘍塞栓摘出術において肘静脈の末梢静脈圧モニタリングを行った症例

    酒井 洋平, 長嶺 祐介, 本庄 俊介, 櫻井 龍, 宮下 徹也, 後藤 隆久

    麻酔   71 ( 10 )   1128 - 1131   2022年10月

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    記述言語:日本語   出版者・発行元:克誠堂出版(株)  

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  • 開腹肝臓切除術後における病棟帰室後の集中治療室入室症例の検討

    伊藤 志緒乃, 長嶺 祐介, 片倉 友美, 天野 れい奈, 宮下 徹也, 後藤 隆久

    麻酔   71 ( 9 )   1008 - 1012   2022年9月

  • The Elevation of Double-Lumen Tube Cuff Pressure During Lung Surgery: A Single-Center Prospective Observational Study☆,☆. 国際誌

    Tomoko Irisawa, Yusuke Nagamine, Masahiro Gamo, Hiroyuki Tanaka, Takahisa Goto

    Journal of cardiothoracic and vascular anesthesia   2022年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: Excessive tracheal tube cuff pressure can cause postoperative complications; however, the variations in the double-lumen tube cuff pressure in lung surgery have not been investigated. This study aimed to determine the incidence and variations in excess double- lumen tube cuff pressure during one-lung ventilation. DESIGN: A prospective observational study. SETTING: Single secondary-care hospital. PARTICIPANTS: Patients aged ≥18 years scheduled for elective lung surgery using a left-sided double-lumen tube. INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: Each cuff of the double-lumen tube was connected to a pressure transducer, and the cuff pressure was continuously measured. The excess cuff pressure and its duration (%) were defined as ≥22 mmHg, and the ratio of the duration of excess cuff pressure to the duration of one-lung ventilation, respectively. In total, 147 patients were included in the final analysis. Eighty patients (54.5%) developed cuff pressure elevation in either cuff and 28 patients (19%) in both cuffs. Younger age, male sex, and left-sided surgery were associated with elevated bronchial cuff pressure. Concurrently, younger age, maximal peak inspiratory pressure, and obstructive respiratory dysfunction were associated with an elevated tracheal cuff pressure. A duration of excess cuff pressure >50% in either cuff was found in 34 patients (23%), and both cuffs in 5 patients (3.4%). The correlation between the duration of tracheal and bronchial excess cuff pressure was poor. CONCLUSIONS: A high incidence and long duration of excess tracheal and bronchial cuff pressure were observed during one-lung ventilation for lung surgery.

    DOI: 10.1053/j.jvca.2022.06.006

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  • 手術を受ける患者の病棟出棟から麻酔導入までの自律神経活動の変化 ウェアラブルデバイスを用いた検証

    岩佐 葵, 福田 真佑, 立石 由紀子, 三浦 友也, 水野 祐介, 赤瀬 智子, 後藤 隆久

    臨床モニター   33 ( Suppl. )   107 - 107   2022年6月

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    記述言語:日本語   出版者・発行元:医学図書出版(株)  

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  • 妊娠33週の肺水腫を契機に診断された左房心臓腫瘍の周術期・集中治療管理の経験

    桑原 香折, 菅原 陽, 長嶺 祐介, 安西 晃子, 横山 暢幸, 濱田 貴子, 高木 俊介, 後藤 隆久

    麻酔   71 ( 6 )   601 - 605   2022年6月

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    記述言語:日本語   出版者・発行元:克誠堂出版(株)  

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  • Effects of wearing surgical masks on fraction of inspired oxygen in spontaneously breathing patients: improving safety for frontline healthcare professionals under pandemic situations. 国際誌

    Kazuhiro Minoguchi, Akira Isii, Toshiki Nakamura, Hitoshi Sato, Takeru Abe, Hiromasa Kawakami, Kyota Nakamura, Takahisa Goto

    BMC anesthesiology   22 ( 1 )   108 - 108   2022年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: During pandemic situations, many guidelines recommend that surgical masks be worn by both healthcare professionals and infected patients in healthcare settings. The purpose of this study was to clarify the levels and changes of oxygen concentration over time while oxygen was administered over a surgical mask. METHODS: Patients scheduled to undergo general anesthesia (n = 99) were enrolled in this study. First, patients were administered oxygen at 6 L/min via an oxygen mask over a surgical mask for 5 min. The patients removed the surgical mask and then took a 3-min break; thereafter, the same amount of oxygen was administered for another 5 min via the oxygen mask. We measured the fraction of inspired oxygen (FiO2), the end-tidal CO2 (EtCO2), and respiratory frequency every minute for 5 min, both while administering oxygen with and without a surgical mask. The FiO2 was measured at the beginning of inspiration and the EtCO2 was measured at the end of expiration. RESULTS: The FiO2 at 5 min was significantly lower when breathing with a surgical mask than that without it (mean difference: 0.08 [95% CI: 0.067-0.10]; p <  0.001). In contrast, the EtCO2 at 5 min was significantly higher when breathing with a surgical mask than that without it (mean difference: 11.9 mmHg [95% CI: 10.9-12.9]; p <  0.001). CONCLUSION: The FiO2 was lower when oxygen was administered over surgical masks than when patients did not wear surgical masks. Oxygen flow may need to be adjusted in moderately ill patients requiring oxygen administration.

    DOI: 10.1186/s12871-022-01649-x

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  • Assessments of prolonged effects of desflurane and sevoflurane on motor learning deficits in aged AppNL-G-F/NL-G-F mice. 査読 国際誌

    Ryo Niikura, Tomoyuki Miyazaki, Kenkichi Takase, Hiroki Sasaguri, Takashi Saito, Takaomi C Saido, Takahisa Goto

    Molecular brain   15 ( 1 )   32 - 32   2022年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    As the proportion of elderly in society increases, so do the number of older patients undergoing surgical procedures. This is concerning as exposure to anesthesia has been identified as a risk factor for Alzheimer's disease (AD). However, the causal relationship between clinical AD development and anesthesia remains conjectural. Preclinical studies have demonstrated that anesthesia, such as halothane, isoflurane, and sevoflurane, induces AD-like pathophysiological changes and cognitive impairments in transgenic mouse models of AD. Desflurane does not have these effects and is expected to have more potential for use in elderly patients, yet little is known about its effects, especially on non-cognitive functions, such as motor and emotional functions. Thus, we examined the postanesthetic effects of desflurane and sevoflurane on motor and emotional function in aged AppNL-G-F/NL-G-F (App-KI) mice. This is a recently developed transgenic mouse model of AD exhibiting amyloid β peptide (Aβ) amyloidosis and a neuroinflammatory response in an age-dependent manner without non-physiological amyloid precursor protein (APP) overexpression. Mice were subjected to a short behavioral test battery consisting of an elevated plus maze, a balance beam test, and a tail suspension test seven days after exposure to 8.0% desflurane for 6 h or 2.8% sevoflurane for 2 h. App-KI mice showed significant increments in the percentage of entry and time spent in open arms in the elevated plus maze, increments in the number of slips and latency to traverse for the balance beam test, increments in the limb clasping score, increments in immobile duration, and decrements in latency to first immobile episode for the tail suspension test compared to age-matched wild type (WT) controls. Desflurane- and sevoflurane-exposed App-KI mice showed a delayed decrement in the number of slips for each trial in the balance beam test, while air-treated App-KI mice rapidly improved their performance, and increased their clasping behavior in the tail suspension test. Furthermore, App-KI inhibited the change in membrane GluA3 following exposure to anesthetics in the cerebellum. These results suggest high validity of App-KI mice as an animal model of AD.

    DOI: 10.1186/s13041-022-00910-1

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  • Predictive factors of postoperative fentanyl consumption in patients with inflammatory bowel disease: a retrospective cohort study. 国際誌

    Sayaka Tsuboi, Kazumi Kubota, Takahiro Mihara, Masataka Taguri, Gaku Inagawa, Takahisa Goto

    BMC anesthesiology   22 ( 1 )   70 - 70   2022年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Patients with inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, might present difficulties in achieving postoperative analgesia. Prior studies have suggested that patients with IBD undergoing major abdominal surgery require higher doses of perioperative opioids than do patients without IBD. Considering patients with IBD potentially require high-dose opioids, identifying those requiring higher opioid doses will allow clinicians to optimize the perioperative opioid dose and avoid insufficient pain management or complications of opioid overdose. Therefore, we conducted this study to identify predictive factors that might influence postoperative opioid consumption in patients with IBD. METHODS: This single-center, historical cohort study reviewed the medical records of all patients admitted to the IBD center of our institution for surgery and who used intravenous fentanyl patient-controlled analgesia (PCA) after open abdominal surgery between June 2013 and April 2017. Ultimately, 179 patients were enrolled in the analysis. Variables expected to influence and/or represent pain, analgesia, inflammation, disease condition, and extent of surgery were selected as potential explanatory variables for predicting postoperative opioid consumption. Multivariable linear regression analysis was used to examine the effect of independent variables on postoperative fentanyl consumption. RESULTS: Of the nine predictive variables selected using the stepwise-selection method, eight were significant. Intraoperative fentanyl consumption, current smoking, ulcerative colitis, administration of biologics during the month before surgery, and the use of supplementary analgesics had a significant increasing effect on postoperative fentanyl consumption, whereas droperidol concentration in the PCA solution, age, and diabetes mellitus had a significant decreasing effect. Preoperative use of opioids was a non-significant variable. The adjusted coefficient of determination was 0.302. CONCLUSIONS: Intraoperative fentanyl consumption, current smoking, ulcerative colitis, administration of biologics during the month before surgery, and the use of supplementary analgesics had a significant increasing effect, whereas droperidol concentration in the PCA solution, age, and diabetes mellitus had a significant decreasing effect on postoperative fentanyl consumption. These factors should be considered when adopting postoperative intravenous fentanyl PCA administration for patients with IBD. TRIAL REGISTRATION: Registry: UMIN Clinical Trials Registry. CLINICAL TRIAL NUMBER: UMIN000031198 . Date of registration: February 8, 2018.

    DOI: 10.1186/s12871-022-01606-8

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  • Sevoflurane-based enhancement of phase-amplitude coupling and localization of the epileptogenic zone. 国際誌

    Keiko Wada, Masaki Sonoda, Ethan Firestone, Kazuki Sakakura, Naoto Kuroda, Yutaro Takayama, Keiya Iijima, Masaki Iwasaki, Takahiro Mihara, Takahisa Goto, Eishi Asano, Tomoyuki Miyazaki

    Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology   134   1 - 8   2022年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Phase-amplitude coupling between high-frequency (≥150 Hz) and delta (3-4 Hz) oscillations - modulation index (MI) - is a promising, objective biomarker of epileptogenicity. We determined whether sevoflurane anesthesia preferentially enhances this metric within the epileptogenic zone. METHODS: This is an observational study of intraoperative electrocorticography data from 621 electrodes chronically implanted into eight patients with drug-resistant, focal epilepsy. All patients were anesthetized with sevoflurane during resective surgery, which subsequently resulted in seizure control. We classified 'removed' and 'retained' brain sites as epileptogenic and non-epileptogenic, respectively. Mixed model analysis determined which anesthetic stage optimized MI-based classification of epileptogenic sites. RESULTS: MI increased as a function of anesthetic stage, ranging from baseline (i.e., oxygen alone) to 2.0 minimum alveolar concentration (MAC) of sevoflurane, preferentially at sites showing higher initial MI values. This phenomenon was accentuated just prior to sevoflurane reaching 2.0 MAC, at which time, the odds of a site being classified as epileptogenic were enhanced by 86.6 times for every increase of 1.0 MI. CONCLUSIONS: Intraoperative MI best localized the epileptogenic zone immediately before sevoflurane reaching 2.0 MAC in this small cohort of patients. SIGNIFICANCE: Prospective, large cohort studies are warranted to determine whether sevoflurane anesthesia can reduce the need for extraoperative, invasive evaluation.

    DOI: 10.1016/j.clinph.2021.11.004

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  • Right ventricular overloading is attenuated in monocrotaline-induced pulmonary hypertension model rats with a disrupted Gpr143 gene, the gene that encodes the 3,4-l-dihydroxyphenyalanine (l-DOPA) receptor.

    Masayuki Nakano, Motokazu Koga, Tatsuo Hashimoto, Natsuki Matsushita, Daiki Masukawa, Yusuke Mizuno, Hiraku Uchimura, Ryo Niikura, Tomoyuki Miyazaki, Fumio Nakamura, Suo Zou, Takahiro Shimizu, Motoaki Saito, Kouichi Tamura, Takahisa Goto, Yoshio Goshima

    Journal of pharmacological sciences   148 ( 2 )   214 - 220   2022年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Pulmonary hypertension (PH) is a severe and progressive disease that causes elevated right ventricular systolic pressure, right ventricular hypertrophy and ultimately right heart failure. However, the underlying pathophysiologic mechanisms are poorly understood. We previously showed that 3,4-l-dihydroxylphenyalanine (DOPA) sensitizes vasomotor response to sympathetic tone via coupling between the adrenergic receptor alpha1 (ADRA1) and a G protein-coupled receptor 143 (GPR143), a DOPA receptor. We investigated whether DOPA similarly enhances ADRA1-mediated contraction in pulmonary arteries isolated from rats, and whether GPR143 is involved in the PH pathogenesis. Pretreating the isolated pulmonary arteries with DOPA 1 μM enhanced vasoconstriction in response to phenylephrine, an ADRA1 agonist, but not to U-46619, a thromboxane A2 agonist or endothelin-1. We generated Gpr143 gene-deficient (Gpr143-/y) rats, and confirmed that DOPA did not augment phenylephrine-induced contractile response in Gpr143-/y rat pulmonary arteries. We utilized a rat model of monocrotaline (MCT)-induced PH. In the MCT model, the right ventricular systolic pressure was attenuated in the Gpr143-/y rats than in WT rats. Phenylephrine-induced cell migration and proliferation were also suppressed in Gpr143-/y pulmonary artery smooth muscle cells than in WT cells. Our result suggests that GPR143 is involved in the PH pathogenesis in the rat models of PH.

    DOI: 10.1016/j.jphs.2021.11.008

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  • Early Alveolar Epithelial Cell Necrosis is a Potential Driver of ARDS with COVID-19

    Kentaro Tojo, Yamamoto Natsuhiro, Nao Tamada, Takahiro Mihara, Miyo Abe, Takahisa Goto

    2022年1月

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    出版者・発行元:Cold Spring Harbor Laboratory  

    Rationale:
    Acute respiratory distress syndrome (ARDS) with COVID-19 is aggravated by hyperinflammatory responses even after passing the peak of viral load. However, the underlying mechanisms remain unclear.

    Objectives :
    Here, we assess whether alveolar epithelial cell necrosis and subsequent releases of damage associated molecular patterns (DAMPs) at an early disease stage aggravate ARDS with COVID-19

    Methods:
    In patients with COVID-19 with and without ARDS and healthy adults, serum levels of the following were quantified: an epithelial total cell death marker, cytokeratin18-M65; an epithelial apoptosis marker, CK18-M30; HMGB-1; and alveolar epithelial and endothelial injury markers, sRAGE, angiopoietin-2, and surfactant protein-D. Molecular mechanisms of alveolar epithelial cell death and effects of HMGB-1 neutralization on alveolar tissue injury were assessed using a mouse model of COVID-19-induced ARDS.

    Measurements and main results:
    The levels of CK18-M65, CK18-M30, and alveolar tissue injury markers were elevated in early stages of ARDS. The median M30/M65 ratio, an epithelial apoptosis indicator, was 31.50% in patients with ARDS, a value significantly lower than that of non-ARDS patients or healthy subjects. Serum levels of HMGB-1, one of DAMPs released from necrotic cells, were also significantly elevated in ARDS versus non-ARDS patients. In a COVID-19-induced ARDS mouse model, alveolar epithelial cell necrosis involved two forms of programmed necrosis, necroptosis and pyroptosis. Finally, neutralization of HMGB-1 attenuated alveolar tissue injury in the mouse model.

    Conclusions:
    Necrosis, including necroptosis and pyroptosis, seems to be the primary form of alveolar epithelial cell death, and subsequent release of DAMPs is a potential driver of COVID-19-induced ARDS.

    DOI: 10.1101/2022.01.23.22269723

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  • Hypotension after general anesthesia induction using remimazolam in geriatric patients: Protocol for a double-blind randomized controlled trial. 国際誌

    Masashi Yokose, Ryuki Takaki, Takahiro Mihara, Yusuke Saigusa, Natsuhiro Yamamoto, Kenichi Masui, Takahisa Goto

    PloS one   17 ( 9 )   e0275451   2022年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: In geriatric patients, hypotension is often reported after general anesthesia induction using propofol. Remimazolam is a novel short-acting sedative. However, the incidence of hypotension after general anesthesia induction using remimazolam in geriatric patients remains unclear. This study aims to compare the incidence of hypotension associated with remimazolam and propofol in patients aged ≥80 years. METHODS: This single-center, double-blind, randomized, two-arm parallel group, standard treatment-controlled, interventional clinical trial will include 90 patients aged ≥80 years undergoing elective surgery under general anesthesia who will be randomized to receive remimazolam or propofol for induction. The primary outcome is the incidence of hypotension after general anesthesia induction, occurring between the start of drug administration and 3 min after intubation. We define hypotension as mean blood pressure <65 mmHg. The primary outcome will be analyzed using the full analysis set. The incidence of hypotension in the two groups will be compared using the Mantel-Haenszel χ2 test. Subgroup analysis of the primary outcome will be performed based on the Charlson comorbidity index, clinical frailty scale, hypertension in the ward, and age. Secondary outcomes will be analyzed using the Fisher's exact test, Student's t test, and Mann-Whitney U test, as appropriate. Logistic regression analysis will be performed to explore the factors associated with the incidence of hypotension after anesthesia induction. DISCUSSION: Our trial will determine the efficacy of remimazolam in preventing hypotension and provide evidence on the usefulness of remimazolam for ensuring hemodynamic stability during general anesthesia induction in geriatric patients. TRIAL REGISTRATION: The study has been registered with UMIN Clinical Trials Registry (UMIN000042587), on June 30, 2021.

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  • L-DOPA受容体(GPR143)による血管平滑筋細胞の遊走と増殖はラットにおけるモノクロタリン誘発性肺高血圧に関与する

    中野 雅友樹, 橋本 達夫, 古賀 資和, 増川 太輝, 奥 真哉, 水野 祐介, 後藤 隆久, 田村 功一, 五嶋 良郎

    日本薬理学会年会要旨集   95   1-YIA-06   2022年

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    記述言語:日本語   出版者・発行元:公益社団法人 日本薬理学会  

    We previously demonstrated that L-DOPA modulated the vascular α1-adrenergic receptor through GPR143, a G-protein coupled receptor, and sensitized vasomotor tone. In this study, we examined a possible role of GPR143 in the pathogeneisis of pulmonary hypertension (PH). In isolated pulmonary arteries, L-DOPA (1 μM) augmented contractile response to phenylephrine, an α1 adrenergic receptor agonist. We generated GPR143 gene-deficient (<i>Gpr143</i><sup><i>-/y</i></sup>) rats and comparatively studied the effect of L-DOPA. L-DOPA did not modify phenylephrine-induced response in the pulmonary arteries of <i>Gpr143</i><sup><i>-/y</i></sup> rats, thereby indicating that the action of L-DOPA was mediated by GPR143. We next established monocrotaline (MCT, 60 mg/kg) -induced PH model in wild type (WT) and <i>Gpr143</i><sup><i>-/y</i></sup> rats. One month after injection subcutaneously with MCT , the right ventricular systolic pressure (RVSP) was attenuated in <i>Gpr143</i><sup><i>-/y</i></sup> rats as compared to the WT rats (49.7 +/- 1.1 mmHg and 41.4 +/- 1.4 mmHg in WT and <i>Gpr143</i><sup><i>-/y</i></sup>, p&lt;0.05, N=5). Coordinately, the right ventricle to body weight (RV/BW) (5.4 +/- 0.2 × 10<sup>-4</sup> and 4.7 +/- 0.1 × 10<sup>-4</sup> in WT and <i>Gpr143</i><sup><i>-/y</i></sup>, p&lt;0.01, N=12) was also reduced in <i>Gpr143</i><sup><i>-/y</i></sup> rats compared to the WT rats. Furthermore, in primary cultures of pulmonary artery smooth muscle cells (PASMCs), the proliferative and migratory capacity of <i>Gpr143</i><sup><i>-/y</i></sup> PASMCs after phenylephrine treatment was reduced compared to <i>Gpr143</i>-WT PASMCs. We here provide evidence that GPR143 may be involved in MCT-induced PH in rats by affecting the proliferative and migratory capacity of PASMCs.

    DOI: 10.1254/jpssuppl.95.0_1-yia-06

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  • Effectiveness of acupuncture therapy for preventing emergence agitation in children: A protocol for systematic review and meta-analysis with trial sequential analysis. 国際誌

    Daisuke Nakajima, Takahiro Mihara, Toshiyuki Hijikata, Makoto Tomita, Takahisa Goto

    PloS one   17 ( 3 )   e0264197   2022年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Pain, autonomic distress, and emergence agitation occur commonly in children undergoing general anesthesia. While acupuncture therapy has been reported to effectively reduce such pain and autonomic distress in children, its effect in preventing emergence agitation remains unclear. Therefore, we will conduct a systematic review and meta-analysis with trial sequential analysis to evaluate the effect of acupuncture therapy in preventing emergence agitation in children undergoing general anesthesia. Methods and analysis This protocol was prepared according to the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for Protocols guidelines. We will conduct a search for randomized controlled trials that evaluated the effect of acupuncture therapy in preventing emergence agitation. The following databases will be searched for relevant articles: MEDLINE, CENTRAL, Embase, and Web of Science; four pre-registration sites will be accessed from inception to April 1, 2021. No language restrictions will be applied. Two authors will independently scan and select eligible studies, extract the data, and assess the risk of bias. The incidence of emergence agitation will be combined as a risk ratio with a 95% confidence interval using a random-effect model. The I2 statistics will be used to assess heterogeneity. We will evaluate the quality of the clinical trials using the Cochrane methodology and assess the quality of evidence using the Grading of Recommendation Assessment, Development, and Evaluation approach. If appropriate, a trial sequential analysis will be performed. Expected outcomes This meta-analysis will be the first to evaluate the effect of acupuncture therapy in preventing emergence agitation in children. The findings from this meta-analysis have the potential to reveal pivotal factors that affect the clinical effect of acupuncture therapy, thereby supporting the optimization of acupuncture therapy for emergence agitation. Protocol registration University Hospital Medical Information Network Clinical Trials Registry (UMIN000040775).

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  • The U-shaped association of serum iron level with disease severity in adult hospitalized patients with COVID-19

    Kentaro Tojo, Yoh Sugawara, Yasufumi Oi, Fumihiro Ogawa, Takuma Higurashi, Yukihiro Yoshimura, Nobuyuki Miyata, Hajime Hayami, Yoshikazu Yamaguchi, Yoko Ishikawa, Ichiro Takeuchi, Natsuo Tachikawa, Takahisa Goto

    Scientific Reports   11 ( 1 )   2021年12月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media LLC  

    <title>Abstract</title>Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that leads to severe respiratory failure (RF). It is known that host exposure to viral infection triggers an iron-lowering response to mitigate pathogenic load and tissue damage. However, the association between host iron-lowering response and COVID-19 severity is not clear. This two-center observational study of 136 adult hospitalized COVID-19 patients analyzed the association between disease severity and initial serum iron, total iron-binding capacity (TIBC), and transferrin saturation (TSAT) levels. Serum iron levels were significantly lower in patients with mild RF than in the non-RF group; however, there were no significant differences in iron levels between the non-RF and severe RF groups, depicting a U-shaped association between serum iron levels and disease severity. TIBC levels decreased significantly with increasing severity; consequently, TSAT was significantly higher in patients with severe RF than in other patients. Multivariate analysis including only patients with RF adjusted for age and sex demonstrated that higher serum iron and TSAT levels were independently associated with the development of severe RF, indicating that inadequate response to lower serum iron might be an exacerbating factor for COVID-19.

    DOI: 10.1038/s41598-021-92921-6

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    その他リンク: http://www.nature.com/articles/s41598-021-92921-6

  • Multivariate analysis of factors associated with first-pass success in blind placement of a post-pyloric feeding tube: a retrospective study. 国際誌

    Kohei Kurisawa, Masashi Yokose, Hiroyuki Tanaka, Takahiro Mihara, Shunsuke Takaki, Takahisa Goto

    Journal of intensive care   9 ( 1 )   59 - 59   2021年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Trans-jejunal nutrition via a post-pyloric enteral feeding tube has a low risk of aspiration or reflux; however, placement of the tube using the blind method can be difficult. Assistive devices, such as fluoroscopy or endoscopy, are useful but may not be suitable for patients with hemodynamic instability or severe respiratory failure. The aim of this study was to explore factors associated with first-pass success in the blind placement of post-pyloric enteral feeding tubes in critically ill patients. METHODS: Data were obtained retrospectively from the medical records of adult patients who had a post-pyloric enteral feeding tube placed in the intensive care unit between January 1, 2012, and December 31, 2018. Logistic regression analysis was performed to assess the association between first-pass success and the independent variables. For logistic regression analysis, the following 13 variables were defined as independent variables: age, sex, height, fluid balance from baseline, use of sedatives, body position during the procedure, use of cardiac assist devices, use of prokinetic agents, presence or absence of intestinal peristalsis, postoperative cardiovascular surgery, use of renal replacement therapy, serum albumin levels, and position of the greater curvature of the stomach in relation to spinal levels L1 - L2. RESULTS: Data obtained from 442 patients were analyzed. The first-pass success rate was 42.8% (n = 189). Logistic regression analysis demonstrated that the position of the greater curvature of the stomach cephalad to L1 - L2 was only associated with successful placement (odds ratio for first-pass success, 0.62; 95% confidence interval: 0.40 - 0.95). CONCLUSIONS: In critically ill patients, the position of the greater curvature of the stomach caudal to L1 - L2 may be associated with a lower first-pass success rate of the blind method for post-pyloric enteral feeding tube placement. Further studies are needed to verify our results because the position of the stomach was estimated by radiographs after enteral feeding tube placement. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry (UMIN000036549; April 20, 2019).

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  • モノクロタリン誘発肺高血圧症ラットの肺動脈におけるprotein kinase Dの役割の解明

    奥 真哉, 長嶺 祐介, 菅原 陽, 水野 祐介, 後藤 隆久

    Cardiovascular Anesthesia   25 ( Suppl. )   89 - 89   2021年10月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

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  • Effect of melatonin and melatonin agonists on postoperative sleep quality in adult patients: a protocol for systematic review and meta-analysis with trial sequential analysis. 国際誌

    Akito Tsukinaga, Takahiro Mihara, Teppei Takeshima, Makoto Tomita, Takahisa Goto, Takeharu Yamanaka

    BMJ open   11 ( 9 )   e047858   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: The circadian rhythm of melatonin secretion is disturbed after general anaesthesia, leading to postoperative sleep disturbance. Small studies investigating the preventive effect of melatonin administration on postoperative sleep disturbance have not reached any conclusions. Therefore, we will conduct a systematic review and meta-analysis to obtain conclusive results. METHODS AND ANALYSIS: We prepared this protocol following the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols guidelines. We will conduct a search for randomised controlled trials that evaluated the effect of melatonin and melatonin agonists on postoperative sleep quality in adult patients undergoing general anaesthesia or regional anaesthesia with sedation. We will exclude patients undergoing regional anaesthesia without sedation. Relevant studies will be searched in the following eight databases: MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, Web of Science and four preregistration sites from inception to 1 January 2021. No language restrictions will be applied. Two authors will independently scan and select eligible studies and perform data extraction and assessment of the risk of bias. The Visual Analogue Scale scores for sleep quality will be combined as the mean difference with a 95% CI using a random-effect model; we will use I2 to assess heterogeneity. We will evaluate the quality of trials using the Cochrane methodology and assess the quality of evidence using the Grading of Recommendation Assessment, Development and Evaluation approach. If appropriate, trial sequential analysis will be performed. ETHICS AND DISSEMINATION: No ethical approval is required for this meta-analysis, as it does not include individual patient data. We will disseminate the results of this meta-analysis in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020180167.

    DOI: 10.1136/bmjopen-2020-047858

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  • 急性腎障害の診断と管理:最新の話題 時系列データを用いた関数ロジスティックモデルによるAKIアラートの構築

    高木 俊介, 三角 俊裕, 根本 貴志, 後藤 隆久

    日本集中治療医学会雑誌   28 ( Suppl.2 )   287 - 287   2021年9月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • Evaluation of respiratory rate monitoring using a microwave Doppler sensor mounted on the ceiling of an intensive care unit: a prospective observational study. 国際誌

    Hiroyuki Tanaka, Masashi Yokose, Shunsuke Takaki, Takahiro Mihara, Yusuke Saigusa, Takahisa Goto

    Journal of clinical monitoring and computing   2021年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Continuous monitoring of the respiratory rate is crucial in an acute care setting. Contact respiratory monitoring modalities such as capnography and thoracic impedance pneumography are prone to artifacts, causing false alarms. Moreover, their cables can restrict patient behavior or interrupt patient care. A microwave Doppler sensor is a novel non-contact continuous respiratory rate monitor. We compared respiratory rate measurements performed with a microwave Doppler sensor mounted on the ceiling of an intensive care unit with those obtained by conventional methods in conscious and spontaneously breathing patients. Participants' respiratory rate was simultaneously measured by visual counting of chest wall movements for 60 s; a microwave Doppler sensor; capnography, using an oxygen mask; and thoracic impedance pneumography, using electrocardiogram electrodes. Bland-Altman analysis for repeated measures was performed to calculate bias and 95% limits of agreement between the respiratory rate measured by visual counting (reference) and that measured by each of the other methods. Among 52 participants, there were 336 (microwave Doppler sensor), 275 (capnography), and 336 (thoracic impedance pneumography) paired respiratory rate data points. Bias (95% limits of agreement) estimates were as follows: microwave Doppler sensor, 0.3 (- 6.1 to 6.8) breaths per minute (bpm); capnography, - 1.3 (- 8.6 to 6.0) bpm; and thoracic impedance pneumography, 0.1 (- 4.4 to 4.7) bpm. Compared to visual counting, the microwave Doppler sensor showed small bias; however, the limits of agreement were similar to those observed in other conventional methods. Our monitor and the conventional ones are not interchangeable with visual counting.Trial registration number: UMIN000032021, March/30/2018.

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  • Intraocular pressure during robotic-assisted laparoscopic prostatectomy: a prospective observational study. 国際誌

    Yuriko Kondo, Noriyuki Echigo, Takahiro Mihara, Yukihide Koyama, Kosuke Takahashi, Kenta Okamura, Takahisa Goto

    Brazilian journal of anesthesiology (Elsevier)   71 ( 6 )   618 - 622   2021年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND OBJECTIVES: Although previous reports have shown intraocular pressure changes during robotic-assisted laparoscopic prostatectomy, they did not discuss the time course of changes or the timing of the largest change. We conducted this study to quantify pressure changes over time in patients assuming the steep Trendelenburg position during robotic-assisted laparoscopic prostatectomy. METHODS: Twenty-one men were enrolled. Intraocular pressure was measured before anesthesia induction in the supine position (T0); 30 (T1), 90 (T2), and 150 minutes after assuming the Trendelenburg position (T3); and 30 minutes after reassuming the supine position (T4). End-tidal carbon dioxide and blood pressure were also recorded. To compare intraocular pressure between the time points, we performed repeated-measures analysis of variance. A mixed-effects multivariate regression analysis was conducted to adjust for confounding factors. RESULTS: The mean (standard deviation) intraocular pressure was 18.3 (2.4), 23.6 (3.0), 25.1 (3.1), 25.3 (2.2), and 18.1 (5.0) mmHg at T0, T1, T2, T3, and T4, respectively. The mean intraocular pressure was higher at T1, T2, and T3 than at T0 (p < 0.0001 for all). There was no significant difference between T0 and T4, and between T3 and T2 (p > 0.99 for both). CONCLUSIONS: The Trendelenburg position during robotic-assisted laparoscopic prostatectomy increased intraocular pressure. The increase was moderate at 90 minutes after the position was assumed, with the value being approximately 7 mmHg higher than the baseline value. The baseline intraocular pressure was restored at 30 minutes after the supine position was reassumed. TRIAL REGISTRATION: UMIN ID 000014973 DATE OF REGISTRATION: August 27, 2014.

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  • 膵頭十二指腸切除術後に内視鏡下で胃内の破損歯を摘出した1症例

    安西 晃子, 岡村 健太, 水野 祐介, 後藤 隆久

    麻酔   70 ( 3 )   297 - 300   2021年3月

  • The U-shaped association of serum iron level with COVID-19 severity: Is iron a potential therapeutic target?

    Kentaro Tojo, Yoh Sugawara, Yasufumi Oi, Fumihiro Ogawa, Takuma Higurashi, Yukihiro Yoshimura, Nobuyuki Miyata, Hajime Hayami, Yoshikazu Yamaguchi, Yoko Ishikawa, Ichiro Takeuchi, Natsuo Tachikawa, Takahisa Goto

    2021年2月

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    出版者・発行元:Cold Spring Harbor Laboratory  

    <title>Abstract</title><sec><title>Objective</title>To evaluate the association between iron metabolism indicators and disease severity in hospitalized patients with coronavirus disease 2019 (COVID-19).

    </sec><sec><title>Design</title>Two-center observational study

    </sec><sec><title>Setting</title>A university hospital and a core hospital in Yokohama, Japan

    </sec><sec><title>Patients</title>Adults with COVID-19 whose serum iron levels were measured within the first 5 days of hospitalization were included. Patients who refused mechanical ventilation were excluded from the study.

    </sec><sec><title>Measurements and Main Results</title>One hundred thirty-six patients were included in this study. We analyzed the association between COVID-19 severity and serum iron, total iron binding capacity (TIBC), and transferrin saturation (TSAT) levels. Disease severity was defined as the worst respiratory status during hospitalization. Serum iron levels were significantly lower in patients with mild respiratory failure (RF) (n=55, median serum iron level: 24 [interquartile range: 19–42] mg/dL) than in the non-RF group (n=44, 40 [24–80] mg/dL) and the severe RF group (n=37, 60 [23.5–87] mg/dL); however, there were no significant differences in iron levels between the non-RF and severe RF groups (non-RF <italic>vs</italic>. mild RF: p=0.019, non-RF <italic>vs</italic>. severe RF: p&gt;0.999, and mild RF <italic>vs</italic>. severe RF: p=0.009). That is, there was a U-shaped association between serum iron levels and disease severity. TIBC levels decreased significantly with increasing severity; consequently, TSAT was significantly higher in patients with severe RF than in other patients. Multivariate analysis including only patients with RF adjusted for age and sex demonstrated that higher serum iron or TSAT levels were independently associated with development of severe RF.

    </sec><sec><title>Conclusions</title>A U-shaped association between serum iron level and RF severity in hospitalized COVID-19 patients was observed. Higher serum iron levels in COVID-19 patients with RF are associated with the development of severe RF, indicating that inadequate response to lower serum iron might be an exacerbating factor for COVID-19.

    </sec>

    DOI: 10.1101/2021.02.19.21252061

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  • A modified algorithm for choosing the most appropriate intraoperative pacemaker mode for patients with permanent pacemaker in non-cardiac surgery.

    Yusaku Terada, Tetsuya Miyashita, Yusuke Nagamine, Takahisa Goto

    Journal of anesthesia   35 ( 1 )   145 - 149   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    To avoid the risk of R-on-T incident and the unnecessary decrease of cardiac output, we devised an algorithm consisting of six steps for choosing the most appropriate intraoperative pacemaker (PM) mode, which is modified from Heart Rhythm Society and the American Society of Anesthesiologists expert consensus statement. Following this algorithm, we reviewed previous operations at our hospital to evaluate the appropriateness of the choices. Six of 78 cases (7.7%) were unfit to the algorithm because of an inappropriate mode change. The PM mode was changed preoperatively in four patients, even though the surgical site was under the umbilicus. In one case of the two other cases, the PM mode was changed from AAI to VOO. This case could not be avoided by the previous algorithm of the expert clinical statements. In another case, the anesthesiologist did not change PM mode even though the patient underwent parotidectomy and his heart rate depended on PM. Prospective research on this algorithm could clarify its usefulness in the future. Moreover, discussions about this algorithm could help develop this field of study and improve the intraoperative management of PMs.

    DOI: 10.1007/s00540-020-02878-5

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  • Distinct temporal characteristics of circulating alveolar epithelial and endothelial injury markers in ARDS with COVID-19: a preliminary retrospective report

    Kentaro Tojo, Natsuhiro Yamamoto, Takahiro Mihara, Miyou Abe, Takahisa Goto

    2021年1月

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    出版者・発行元:Cold Spring Harbor Laboratory  

    The time course and specific contributions of alveolar epithelial and endothelial injury to the pathogenesis of acute respiratory distress syndrome (ARDS) with coronavirus disease (COVID-19) remain unclear. Here, we evaluated the characteristics of circulating markers of alveolar epithelial and endothelial injury in serum samples from eleven ARDS patients and ten non-ARDS patients, all with COVID-19. Our results indicates that the alveolar epithelial injury at the very early disease stage and the endothelial injury which continues to exacerbate during the later disease stage seem to be the hallmarks of ARDS with COVID-19.

    DOI: 10.1101/2021.01.10.21249528

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  • Prevalence of neuropathic pain in terminally ill patients with cancer admitted to a general ward: a prospective observational study. 国際誌

    Ryota Yanaizumi, Yusuke Nagamine, Shinsuke Harada, Keiko Kojima, Toshiharu Tazawa, Takahisa Goto

    The Journal of international medical research   49 ( 1 )   300060520987726 - 300060520987726   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: To determine the prevalence of neuropathic pain among terminally ill patients with cancer admitted to a general ward, using the International Association for the Study of Pain algorithm. METHODS: This prospective observational study was conducted at a tertiary care center. We enrolled terminally ill patients with cancer admitted to the general ward between September 2018 and September 2019. On the day of consultation with our palliative care team, pain management clinicians examined and diagnosed neuropathic pain using the International Association for the Study of Pain diagnostic criteria. RESULTS: A total of 108 patients were enrolled during the study period. The median age was 69 years (interquartile range [IQR] 58.3-76.8 years), 72 patients (66.7%) were men, and the median survival time was 33 days (IQR 14.3-62 days). Of the 108 patients, 33 (30.6%) had neuropathic pain. Patients with neuropathic pain had more severe pain than those without neuropathic pain. CONCLUSIONS: The prevalence of neuropathic pain in terminally ill patients with cancer admitted to a Japanese general ward was 30.6%. Further studies are warranted to elucidate whether the accurate diagnosis of neuropathic pain can improve pain control and/or patient conditions.

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  • Association of chorioamnionitis with failed conversion of epidural labor analgesia to cesarean delivery anesthesia: A retrospective cohort study. 国際誌

    Yumi Katakura, Yusuke Nagamine, Takahisa Goto, Hiroyuki Sumikura

    PloS one   16 ( 5 )   e0250596   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: This study aimed to examine the association between clinically diagnosed chorioamnionitis and failed conversion of epidural labor analgesia to cesarean delivery anesthesia. METHODS: This retrospective, single-center cohort study, conducted in a university hospital, enrolled term parturients undergoing emergency cesarean section after induction of epidural labor analgesia between September 2015 and May 2019. For the purpose of this study, all cases were re-examined to ensure that they fulfilled the criteria of chorioamnionitis, regardless of the actual indication for cesarean section proposed by obstetricians at the time of application. The primary outcome was failure of conversion of epidural labor analgesia to cesarean delivery anesthesia. Multivariable logistic regression analysis was performed to investigate the association between chorioamnionitis and failure of anesthesia for cesarean section. RESULTS: Among the 180 parturients reviewed, 58 (43.9%) fulfilled the criteria for chorioamnionitis. Failure of epidural conversion in the chorioamnionitis (+) group was significantly higher than in the chorioamnionitis (-) group (46.6% [27/58] vs. 18.9% [14/74], crude odds ratio = 3.7, 95% confidence interval: 1.7-8.3). After adjustment for potential confounders (age, body mass index, multiparity, and duration for epidural labor analgesia), chorioamnionitis was found to be associated with failure of anesthesia for cesarean sections (adjusted odds ratio = 3.6, 95% confidence interval: 1.6-8.4). CONCLUSIONS: Chorioamnionitis is associated with the failed conversion of epidural labor analgesia to cesarean delivery anesthesia.

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  • The psychological effects of COVID-19 on hospital workers at the beginning of the outbreak with a large disease cluster on the Diamond Princess cruise ship. 国際誌

    Keiko Ide, Takeshi Asami, Akira Suda, Asuka Yoshimi, Junichi Fujita, Munetaka Nomoto, Tomohide Roppongi, Kousuke Hino, Yuichi Takahashi, Kaori Watanabe, Tomoko Shimada, Toyoko Hamasaki, Emi Endo, Tomoko Kaneko, Michiko Suzuki, Kazumi Kubota, Yusuke Saigusa, Hideaki Kato, Toshinari Odawara, Hideaki Nakajima, Ichiro Takeuchi, Takahisa Goto, Michiko Aihara, Akitoyo Hishimoto

    PloS one   16 ( 1 )   e0245294   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The aim of the present study was to investigate the psychological effects of the COVID-19 outbreak and associated factors on hospital workers at the beginning of the outbreak with a large disease cluster on the Diamond Princess cruise ship. This cross-sectional, survey-based study collected demographic data, mental health measurements, and stress-related questionnaires from workers in 2 hospitals in Yokohama, Japan, from March 23, 2020, to April 6, 2020. The prevalence rates of general psychological distress and event-related distress were assessed using the 12-item General Health Questionnaire (GHQ-12) and the 22-item Impact of Event Scale-Revised (IES-R), respectively. Exploratory factor analysis was conducted on the 26-item stress-related questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes for workers both at high- and low-risk for infection of COVID-19. A questionnaire was distributed to 4133 hospital workers, and 2697 (65.3%) valid questionnaires were used for analyses. Overall, 536 (20.0%) were high-risk workers, 944 (35.0%) of all hospital workers showed general distress, and 189 (7.0%) demonstrated event-related distress. Multivariable logistic regression analyses revealed that 'Feeling of being isolated and discriminated' was associated with both the general and event-related distress for both the high- and low-risk workers. In this survey, not only high-risk workers but also low-risk workers in the hospitals admitting COVID-19 patients reported experiencing psychological distress at the beginning of the outbreak.

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  • Impact of anesthetic agents on the amount of bleeding during dilatation and evacuation: A systematic review and meta-analysis. 国際誌

    Hyun Ah Lee, Hiromasa Kawakami, Takahiro Mihara, Hitoshi Sato, Takahisa Goto

    PloS one   16 ( 12 )   e0261494   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Patients undergo dilatation and evacuation for abortion or miscarriage. However, bleeding is sometimes problematic. Despite reports on the association between volatile anesthetics and increased bleeding during the procedure, firm evidence is lacking. Therefore, we conducted a systematic review and meta-analysis to compare the effects of volatile anesthetics and propofol on the amount of bleeding in patients undergoing dilatation and evacuation. METHODS: We conducted a systematic search of four databases, namely PubMed, Embase, Cochrane Central Register of Controlled Trials databases, and Web of Science (Clarivate Analytics), from their respective inception to April 2021. Moreover, we searched two trial registration sites. The inclusion criterion was randomized controlled trials of patients who underwent dilatation and evacuation under general anesthesia using volatile anesthetics or propofol. The primary outcome was the amount of perioperative bleeding. The mean difference of the bleeding was combined using a random-effects model. The I2 statistic was used to assess heterogeneity. We assessed risk of bias with Cochrane domains. We controlled type I and II errors due to sparse data and repetitive testing with Trial Sequential Analysis. We assessed the quality of evidence with GRADE. RESULTS: Five studies were included in the systematic review. The amount of bleeding was compared in four studies and was higher in the volatile anesthetic group, with a mean difference of 164.7 ml (95% confidence interval, 43.6 to 285.7; p = 0.04). Heterogeneity was considerable, with an I2 value of 97%. Two studies evaluated the incidence of significant bleeding, which was significantly higher in the volatile anesthetic group (RR, 2.42; 95% confidence interval, 1.04-5.63; p = 0.04). CONCLUSION: Choosing propofol over volatile anesthetics during dilatation and evacuation might reduce bleeding and the incidence of excessive bleeding. However, the quality of the evidence was very low. This necessitates further trials with a low risk of bias. TRIAL REGISTRATION: PROSPERO (CRD42019120873).

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  • CLP290 promotes the sedative effects of midazolam in neonatal rats in a KCC2-dependent manner: A laboratory study in rats. 国際誌

    Akiko Doi, Tomoyuki Miyazaki, Takahiro Mihara, Maiko Ikeda, Ryo Niikura, Tomio Andoh, Takahisa Goto

    PloS one   16 ( 3 )   e0248113   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Immature neurons dominantly express the Na+-K+-2Cl- cotransporter isoform 1 (NKCC1) rather than the K+-Cl- cotransporter isoform 2 (KCC2). The intracellular chloride ion concentration ([Cl-]i) is higher in immature neurons than in mature neurons; therefore, γ-aminobutyric acid type A (GABAA) receptor activation in immature neurons does not cause chloride ion influx and subsequent hyperpolarization. In our previous work, we found that midazolam, benzodiazepine receptor agonist, causes less sedation in neonatal rats compared to adult rats and that NKCC1 blockade by bumetanide enhances the midazolam-induced sedation in neonatal, but not in adult, rats. These results suggest that GABA receptor activation requires the predominance of KCC2 over NKCC1 to exert sedative effects. In this study, we focused on CLP290, a novel KCC2-selective activator, and found that midazolam administration at 20 mg/kg after oral CLP290 intake significantly prolonged the righting reflex latency even in neonatal rats at postnatal day 7. By contrast, CLP290 alone did not exert sedative effects. Immunohistochemistry showed that midazolam combined with CLP290 decreased the number of phosphorylated cAMP response element-binding protein-positive cells in the cerebral cortex, suggesting that CLP290 reverted the inhibitory effect of midazolam. Moreover, the sedative effect of combined CLP290 and midazolam treatment was inhibited by the administration of the KCC2-selective inhibitor VU0463271, suggesting indirectly that the sedation-promoting effect of CLP290 was mediated by KCC2 activation. To our knowledge, this study is the first report showing the sedation-promoting effect of CLP290 in neonates and providing behavioral and histological evidence that CLP290 reverted the sedative effect of GABAergic drugs through the activation of KCC2. Our data suggest that the clinical application of CLP290 may provide a breakthrough in terms of midazolam-resistant sedation.

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  • Preventive effect of ramelteon on emergence agitation after general anaesthesia in paediatric patients undergoing tonsillectomy: a randomised, placebo-controlled clinical trial. 国際誌

    Maya Komazaki, Takahiro Mihara, Nobuhito Nakamura, Koui Ka, Takahisa Goto

    Scientific reports   10 ( 1 )   21996 - 21996   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Purpose of this prospective, double-blind, parallel-group, placebo-controlled, randomised clinical trial was to confirm our hypothesis that ramelteon has a preventive effect on emergence agitation after general anaesthesia in children. Patients aged 18 to 119 months (ASA physical status 1 or 2), scheduled to undergo tonsillectomy under general anaesthesia, were randomly allocated to the ramelteon or placebo group. Before general anaesthesia induction, patients in the ramelteon group received 0.1 mg kg-1 of ramelteon dissolved in 5 mL of lactose-containing syrup. The patients in the placebo group received the same amount of syrup alone. The Paediatric Anaesthesia Emergence Delirium score was calculated every 5 min after awakening. The primary outcome was the incidence of emergence agitation (Paediatric Anaesthesia Emergence Delirium score ≥ 10). Paediatric Anaesthesia Emergence Delirium scores, post-operative vomiting incidence, pain scores, and adverse events were secondary outcomes. Fifty patients were enrolled. Forty-eight patients were analysed. There was no significant between-group difference in the incidence of emergence agitation (67% in both groups; risk ratio, 1.0; 95% CI 0.67-1.49; P > 0.99) or any of the secondary outcomes. Our results suggest that 0.1 mg kg-1 of ramelteon does not have a preventive effect on emergence agitation after general anaesthesia in children undergoing tonsillectomy.

    DOI: 10.1038/s41598-020-79078-4

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  • Exploratory analyses of postanesthetic effects of desflurane using behavioral test battery of mice. 国際誌

    Ryo Niikura, Tomoyuki Miyazaki, Kumiko Yonezaki, Kazuhiro Uchimoto, Kenkichi Takase, Takahisa Goto

    Behavioural pharmacology   31 ( 7 )   597 - 609   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Halogenated ethers, such as desflurane, sevoflurane, and isoflurane, are known to exert an array of effects besides sedation. However, the postanesthetic effects of desflurane remain undiscovered as no study has explored these effects systematically. Phenotypic screening using behavioral test batteries is a powerful method to identify such effects. In the present study, we behaviorally phenotyped desflurane-treated mice to investigate postanesthetic effects. We applied comprehensive behavioral test batteries measuring sensorimotor functions, anxiety, depression, sociability, attention, and learning abilities, starting 7 days after anesthesia performed with 8.0% desflurane for 6 h. Although our previous study revealed postanesthetic effects of isoflurane in adult mice, in the current study, desflurane-treated mice exhibited no such effects in any behavioral test. To further examine whether desflurane affect behavior in more early time point, we built up a new additional test battery, which carried out 1 day or 3 days after exposure to desflurane. Mice treated with desflurane 1 day before testing showed more slips than other two groups in the first trial, suggesting mild acute side effects of desflurane on motor coordination. These results suggest the safety of desflurane in clinical settings and imply that postanesthetic effects are unique to each halogenated ether.

    DOI: 10.1097/FBP.0000000000000567

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  • Risk factors for prolonged postoperative oxygen supplementation dependence after surgical lung biopsy in patients with interstitial pneumonia: A single-center, retrospective, observational study. 国際誌

    Natsuhiro Yamamoto, Akiko Anzai, Kenta Okamura, Masahiro Gamo, Takahisa Goto

    Journal of clinical anesthesia   65   109878 - 109878   2020年10月

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  • 高い吸入酸素濃度はARDSにおいて無気肺に伴う肺組織低酸素及び肺傷害を軽減しない

    東條 健太郎, 矢澤 卓也, 後藤 隆久

    日本集中治療医学会雑誌   27 ( Suppl. )   658 - 658   2020年9月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • Airway management strategy for accidental tracheal extubation in the prone position: A simulation study. 国際誌

    Natsuhiro Yamamoto, Akira Ishii, Tetsuya Miyashita, Takahisa Goto

    Journal of clinical anesthesia   63   109786 - 109786   2020年8月

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  • Transfusion characteristics and hemostatic conditions in octogenarians undergoing emergency surgery for acute aortic dissection: a retrospective study. 国際誌

    Tetsuhito Masubuchi, Kenji Yoshitani, Kimito Minami, Chisaki Yokoyama, Akito Tsukinaga, Takahisa Goto, Yoshihiko Ohnishi

    JA clinical reports   6 ( 1 )   52 - 52   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The number of elderly patients undergoing elective as well as emergent cardiac surgery is increasing. Octogenarian and older patients undergoing surgery for acute type A aortic dissection (AAD) have a significantly higher risk of postoperative mortality than younger patients. Hemostasis is difficult in octogenarians with AAD. However, few studies have investigated perioperative blood transfusion volumes and hemostatic conditions in patients undergoing AAD surgery. We retrospectively investigated whether these factors differed between octogenarians and younger patients with AAD. METHODS: The records of 207 patients who underwent emergency surgery for AAD were reviewed between 2008 and 2014. We compared the total volumes of transfused blood components (red blood cell concentrate, fresh frozen plasma, platelets concentrate, and cryoprecipitate), perioperative blood coagulation test results (prothrombin time-international normalized ratio, activated partial thrombin time, and activated coagulation time), and intensive care unit and hospital stay durations between octogenarians (n = 33) and patients < 80 years old (n = 170). RESULTS: A significantly greater volume of red blood cell concentrates was transfused in octogenarians than in patients < 80 years old. Isolated prolonged activated partial thromboplastin time was observed in octogenarian patients. Duration of hospital stays was significantly longer in octogenarians than in patients < 80 years old. CONCLUSIONS: Octogenarians required more red blood cells during surgery for AAD and exhibited isolated APTT prolongation.

    DOI: 10.1186/s40981-020-00358-z

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  • Anterior quadratus lumborum block for postoperative recovery after total hip arthroplasty: a study protocol for a single-center, double-blind, randomized controlled trial. 査読 国際誌

    Masaru Kikuchi, Takahiro Mihara, Yusuke Mizuno, Hiroko Fujimoto, Sachiko Arai, Takeshi Nomura, Takahisa Goto

    Trials   21 ( 1 )   142 - 142   2020年2月

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    記述言語:英語  

    BACKGROUND: Appropriate pain management is essential to improve the postoperative recovery after total hip arthroplasty (THA). Various case reports have indicated that anterior quadratus lumborum block (QLB) provides effective postoperative analgesia in lower limb surgeries. However, few randomized controlled trials have confirmed the efficacy of anterior QLB for lower limb surgeries. The aim of this single-center, double-blind, randomized controlled trial is to confirm the efficacy of anterior QLB for postoperative recovery after THA. METHODS: The participants will be randomly assigned to either the anterior QLB or placebo groups, using a set of random numbers for the allocation sequence. Only pharmacists will be aware of the allocations; other investigators will be blinded until study completion. After induction of general anesthesia, anterior QLB will be performed by using 0.25% levobupivacaine or normal saline. Fentanyl will be administered according to blood pressure change during the surgery. The primary outcome will be the quality of recovery 40 score (QoR-40). Secondary outcomes will include the visual analog scale score of pain intensity at rest and movement, intraoperative and postoperative doses of fentanyl, and incidence of postoperative nausea and vomiting. Statistical analysis will be performed by using the Student's t test, Mann-Whitney U test, and Fisher's exact test as appropriate. A P value of less than 0.05 will be considered statistically significant. DISCUSSION: The results of our study will reveal whether anterior QLB is effective for postoperative recovery after THA. TRIAL REGISTRATION: UMIN Clinical Trials Registry, UMIN000032255. Registered on 15 April 2018.

    DOI: 10.1186/s13063-020-4090-0

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  • L-DOPA受容体(GPR143)はラットにおけるモノクロタリン誘発性肺高血圧に関与する

    中野 雅友樹, 橋本 達夫, 古賀 資和, 増川 太輝, 奥 真哉, 水野 祐介, 後藤 隆久, 田村 功一, 五嶋 良郎

    日本薬理学会年会要旨集   93   1-YIA-23   2020年

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    記述言語:日本語   出版者・発行元:公益社団法人 日本薬理学会  

    We previously demonstrated that L-DOPA modulated the vascular α1-adrenergic receptor through GPR143, a G-protein coupled receptor, and sensitized vasomotor tone. The purpose of this study is to clarify the involvement of GPR143, in pulmonary hypertension (PH). We generated GPR143 gene-deficient (KO) rats and comparatively studied monocrotaline (MCT) -induced PH in wild type (WT) and <i>Gpr143</i>-KO rats. We evaluated the interaction between L-DOPA and adrenergic α1 receptor by contractile force of rat isolated pulmonary arteries. The degree of PH was evaluated by right ventricular systolic pressure (RVSP) and right ventricular to body weight ratio (RV/BW). In isolated pulmonary arteries, L-DOPA ( 1 μM) augmented contractile response to phenylephrine, an α1 adrenergic receptor agonist. One month after injection subcutaneously with MCT (60 mg/kg), the RVSP was attenuated in <i>Gpr143</i>-KO rats as compared to the WT rats (49.7 +/- 1.1 mmHg and 41.1 +/- 1.4 mmHg in WT and <i>Gpr143</i>-KO, p&lt;0.01, N=5). Coordinately, the RV/BW was also reduced in <i>Gpr143</i>-KO rats compared to the WT rats (5.8 +/- 0.3 × 10<sup>-4</sup> and 4.9 +/- 0.2 × 10<sup>-4</sup> in WT and <i>Gpr143</i>-KO, p&lt;0.05, N=7). We here provide evidence that GPR143 is involved in MCT-induced PH in rats. Further studies are needed to elucidate detailed mechanisms.

    DOI: 10.1254/jpssuppl.93.0_1-yia-23

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  • Perioperative and anesthetic risk factors of surgical site infection in patients undergoing pancreaticoduodenectomy: A retrospective cohort study. 国際誌

    Saori Yamamoto, Yusuke Nagamine, Tetsuya Miyashita, Shiono Ito, Yurika Iwasawa, Michihiko Kawai, Shinsaku Saito, Tomohisa Tamai, Takahisa Goto

    PloS one   15 ( 10 )   e0240490   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Surgical site infection is a major perioperative issue. The morbidity of surgical site infection is high in major digestive surgery, such as pancreaticoduodenectomy. The comprehensive risk factors, including anesthetic factors, for surgical site infection in pancreaticoduodenectomy are unknown. The aim of this study was to investigate the perioperative and anesthetic risk factors of surgical site infection in pancreaticoduodenectomy. METHODS: This was a retrospective cohort study conducted in a single tertiary care center. A total of 326 consecutive patients who underwent pancreaticoduodenectomy between January 2009 and March 2018 were evaluated. Patients who underwent resection of other organs were excluded. The primary outcome was the incidence of surgical site infection, based on a Clavien-Dindo classification of grade 2 or higher. Multivariable logistic regression analysis was performed to investigate the association between surgical site infection and perioperative and anesthetic factors. RESULTS: Of the 326 patients, 116 (35.6%) were women. The median age was 70 years (interquartile range; 64-75). The median duration of surgery was 10.9 hours (interquartile range; 9.5-12.4). Surgical site infection occurred in 60 patients (18.4%). The multivariable analysis revealed that the use of desflurane as a maintenance anesthetic was associated with a significantly lower risk of surgical site infection than sevoflurane (odds ratio, 0.503; 95% confidence interval [CI], 0.260-0.973). In contrast, the duration of surgery (odds ratio, 1.162; 95% CI, 1.017-1.328), cerebrovascular disease (odds ratio, 3.544; 95% CI, 1.326-9.469), and ischemic heart disease (odds ratio, 10.839; 95% CI, 1.887-62.249) were identified as significant risk factors of surgical site infection. CONCLUSIONS: Desflurane may be better than sevoflurane in preventing surgical site infection in pancreaticoduodenectomy. Cerebrovascular disease and ischemic heart disease are potential newly-identified risk factors of surgical site infection in pancreaticoduodenectomy.

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  • Effectiveness of intravenous lidocaine in preventing postoperative nausea and vomiting in pediatric patients: A systematic review and meta-analysis. 査読 国際誌

    Daisuke Nakajima, Hiromasa Kawakami, Takahiro Mihara, Hitoshi Sato, Takahisa Goto

    PloS one   15 ( 1 )   e0227904   2020年

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    記述言語:英語  

    BACKGROUND: Intravenous lidocaine in adults undergoing general anesthesia has been shown to reduce the incidence of postoperative nausea and vomiting (PONV). However, the anti-postoperative vomiting (POV) effect of lidocaine in pediatric patients remains unclear. We conducted a systematic review and meta-analysis with Trial Sequential Analysis to evaluate the effect of intravenous lidocaine on prevention of POV/PONV. METHODS: Six databases including trial registration sites were searched. Randomized clinical trials evaluating the incidence of POV/PONV after intravenous lidocaine compared with control were included. The primary outcome was the incidence of POV within 24 hours after general anesthesia. The incidence of POV was combined as a risk ratio with 95% confidence interval using a random-effect model. We used the I2 to assess heterogeneity. We evaluated the quality of trials using the Cochrane methodology, and we assessed quality of evidence using the Grading of Recommendation Assessment, Development, and Evaluation approach. We also assessed adverse events. RESULTS AND DISCUSSION: Six trials with 849 patients were included, of whom 433 received intravenous lidocaine. Three trials evaluated the incidence of POV, and 3 evaluated the incidence of PONV. The overall incidence of POV within 24 hours after anesthesia was 45.9% in the lidocaine group and 63.4% in the control group (risk ratio, 0.73; 95% confidence interval, 0.53-1.00; I2 = 32%; p = 0.05). The incidence of PONV within 24 hours after anesthesia was 3.73% in the lidocaine group and 4.87% in the control group (RR, 0.76; 95% CI, 0.36-1.59; I2 = 0%; p = 0.47). The quality of evidence was downgraded to "very low" due to the study designs, inconsistency, imprecision, and possible publication bias. CONCLUSION: Our meta-analysis suggests that intravenous lidocaine infusion may reduce the incidence of POV, however, the evidence quality was "very low." Further trials with a low risk of bias are necessary.

    DOI: 10.1371/journal.pone.0227904

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  • The Difference Between Set and Delivered Tidal Volume: A Lung Simulation Study. 国際誌

    Yoshikazu Yamaguchi, Tetsuya Miyashita, Yuko Matsuda, Makoto Sasaki, Shunsuke Takaki, Stephani S Kim, Joseph D Tobias, Takahisa Goto

    Medical devices (Auckland, N.Z.)   13   205 - 211   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Precise control of tidal volume is one of the keys in limiting ventilator-induced lung injury and ensuring adequate ventilation in mechanically ventilated neonates. The aim of the study was to compare the tidal volume (mVT) measured from the expiratory limb of the ventilator with the actual tidal volume (aVT) that would be delivered to the patient using a lung model to simulate a neonate. Methods: This study was conducted using the ASL5000 lung simulator. Three combinations of parameters were set: resistance (cmH2O/L/sec) and compliance (mL/cmH2O) of 50 and 2 (Group 1), 100 and 1 (Group 2), and 150 and 0.5 (Group 3), respectively. The ASL5000 was connected to each of the ventilators including one anesthesia machine ventilator (Drager Fabius GS) and two ICU ventilators (Servo-i Universal and Evita Infinity V500). Each ventilator was evaluated with a set tidal volume of 30 mL (sVT) and a respiratory rate of 25 breathes/minute in both the volume-controlled ventilation (VCV) and dual-controlled ventilation (DCV) modes. Results: The discrepancies between sVT, mVT and aVT were highest with the Fabius anesthesia machine ventilator and increased in the simulated lung injury groups. When comparing the ICU ventilators, the difference was greater the Servo-i and increased when using the DCV mode and with simulated lung injury. Conclusion: Accurate tidal volumes were achieved only with the Infinity ICU ventilator. This was true regardless of mode of ventilation and even during simulated lung injury.

    DOI: 10.2147/MDER.S259760

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  • A question is "what are the optimal targets for anticoagulant therapies?" 査読 国際誌

    Nobuyuki Yokoyama, Shunsuke Takaki, Masashi Yokose, Kaori Kuwabara, Akiko Anzai, Takako Hamada, Shizuka Kashiwagi, Kenta Okamura, Yoh Sugawara, Takahisa Goto

    Journal of intensive care   8   17 - 17   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A high mortality rate is found among septic patients with disseminated intravascular coagulation (DIC). Anticoagulants have been used for treating septic DIC especially in Japanese clinical settings; however, their effectiveness is quite controversial across studies. According to several randomized controlled trials and meta-analyses, antithrombin and recombinant thrombomodulin had no therapeutic benefit in the treatment of sepsis. However, the majority of the previous research did not discuss "septic DIC" but simply "sepsis", and some reviews showed that anticoagulants were benefit only in septic DIC. Although immunothrombosis plays an important role in early host defense, it can lead to DIC and organ failure if dysregulated. Therefore, we advocate anticoagulant therapies might have beneficial effects, but research on optimal patient selection is currently lacking.

    DOI: 10.1186/s40560-020-0434-9

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  • Effects of intravenous dextrose on preventing postoperative nausea and vomiting: A systematic review and meta-analysis with trial sequential analysis. 査読 国際誌

    Chisaki Yokoyama, Takahiro Mihara, Shizuka Kashiwagi, Motokazu Koga, Takahisa Goto

    PloS one   15 ( 4 )   e0231958   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: It is reported that postoperative nausea and vomiting, common general anesthesia complications, may be prevented by perioperative intravenous dextrose administration, but with controversial clinical effectiveness. OBJECTIVE: To evaluate perioperative intravenous dextrose for preventing postoperative nausea and vomiting through a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis. DATA SOURCES: MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, Web of Science, clinicaltrials.gov, and the University Hospital Medical Information Network Clinical Trials Registry were searched from inception until 22 June 2019. ELIGIBILITY CRITERIA: Trials investigating intravenous dextrose effects vs. placebos on postoperative nausea and vomiting in patients who underwent general anesthesia. RESULTS: Eleven trials (1,250 patients) were included. All participants were ASA1-2. The nine trials included laparoscopic surgeries, and 92.2% of the participants were women. The timing of dextrose infusion was before, during, and after surgery in three, five, and three trials, respectively. Our results revealed intravenous dextrose administration significantly reduced postoperative nausea, but not vomiting, during early and late postoperative periods (risk ratio [95% confidence interval], early nausea: 0.76 [0.59-0.99], late nausea: 0.65 [0.48-0.89]; early vomiting: 1.00 [0.81-1.25], late vomiting: 0.96 [0.43-2.16]). Evidence quality was downgraded to low because the trial sequential analysis indicated more trials are needed for firm conclusions. CONCLUSIONS: Compared with placebos, perioperative intravenous dextrose administration may decrease postoperative nausea but not vomiting. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry (registration number: UMIN000030901).

    DOI: 10.1371/journal.pone.0231958

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  • Effects of intraoperative tidal volume on incidence of acute kidney injury after cardiovascular surgery: A retrospective cohort study 査読

    Tojo K, Mihara T, Goto T

    Journal of Critical Care   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.jcrc.2019.12.020

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  • Pre-anesthetic ultrasonographic assessment of the internal jugular vein for prediction of hypotension during the induction of general anesthesia.

    Kenta Okamura, Takeshi Nomura, Yusuke Mizuno, Tetsuya Miyashita, Takahisa Goto

    Journal of anesthesia   33 ( 5 )   612 - 619   2019年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Severe hypotension caused by anesthetic administration for anesthesia induction, which might cause ischemic stroke, myocardial injury, acute kidney injury and postoperative mortality, should be prevented. Anesthesiologists are familiar with ultrasound examination of the internal jugular vein (IJV). This study aimed to clarify whether ultrasonographic IJV evaluation just before induction could predict the occurrence of such hypotension. METHODS: Adult patients undergoing surgery under general anesthesia were enrolled after excluding patients with cardiovascular disease or ASA-PS ≥ III. Ultrasonographic IJV images were recorded in both the supine and 10° Trendelenburg positions immediately before induction. Using these images, IJV area (IJV-A), diameter and change rate with posture were measured. Hypotension during induction was defined as mean BP < 60 mmHg or > 30% decrease from baseline. RESULTS: Hypotension during induction was observed in 37 of 82 patients. IJV-A in the Trendelenburg position was 2.02 ± 0.86 and 1.72 ± 0.68 in the hypotensive and non-hypotensive groups, respectively (P = 0.08). Logistic regression analysis performed using age, use of calcium antagonists, angiotensin converting enzyme inhibitors/angiotensin receptor blockers, baseline mean BP and IJV-A in the Trendelenburg position as variables showed that IJV-A in the Trendelenburg position was an independent predictor of hypotension, with an adjusted odds ratio of 3.11 (95% CI 1.07-9.03, P = 0.04). Area under the curve was 0.595 (95% CI 0.469-0.722) for IJV-A in the Trendelenburg position. CONCLUSION: IJV-A in the Trendelenburg position was an independent predictor of hypotension during induction. Further study is required to examine the diagnostic accuracy of IJV-A as a predictor for hypotension during induction.

    DOI: 10.1007/s00540-019-02675-9

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  • Low hematocrit levels: a risk factor for long-term outcomes in patients requiring prolonged mechanical ventilation after cardiovascular surgery. A retrospective study. 査読

    Tsukinaga A, Takaki S, Mihara T, Okamura K, Isoda S, Kurahashi K, Goto T

    J Investig Med.   Sep 26   2019年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Effectiveness of Magnesium in Preventing Shivering in Surgical Patients: A Systematic Review and Meta-analysis. 査読 国際誌

    Hiromasa Kawakami, Daisuke Nakajima, Takahiro Mihara, Hitoshi Sato, Takahisa Goto

    Anesthesia and analgesia   129 ( 3 )   689 - 700   2019年9月

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    記述言語:英語  

    BACKGROUND: Clinical trials regarding the antishivering effect of perioperative magnesium have produced inconsistent results. We conducted a systematic review and meta-analysis with Trial Sequential Analysis to evaluate the effect of perioperative magnesium on prevention of shivering. METHODS: We searched PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and 2 registry sites for randomized clinical trials that compared the administration of magnesium to a placebo or no treatment in patients undergoing surgeries. The primary outcome of this meta-analysis was the incidence of shivering. The incidence of shivering was combined as a risk ratio with 95% CI using a random-effect model. The effect of the route of administration was evaluated in a subgroup analysis, and Trial Sequential Analysis with a risk of type 1 error of 5% and power of 90% was performed. The quality of each included trial was evaluated, and the quality of evidence was assessed using the Grading of Recommendation Assessment, Development, and Evaluation approach. We also assessed adverse events. RESULTS: Sixty-four trials and 4303 patients (2300 and 2003 patients in magnesium and control groups, respectively) were included. The overall incidence of shivering was 9.9% in the magnesium group and 23.0% in the control group (risk ratio, 0.42; 95% CI, 0.33-0.52). Subgroup analysis revealed that the incidence of shivering was lower with IV (risk ratio, 0.29; 95% CI, 0.29-0.54; Grading of Recommendation Assessment, Development, and Evaluation, moderate), epidural (risk ratio, 0.24; 95% CI, 0.13-0.43; Grading of Recommendation Assessment, Development, and Evaluation, low), and intrathecal administration (risk ratio, 0.64; 95% CI, 0.43-0.96; Grading of Recommendation Assessment, Development, and Evaluation, moderate). Only trials with low risk of bias were included for Trial Sequential Analysis. The Z-cumulative curve for IV magnesium crossed the Trial Sequential Analysis monitoring boundary for benefit even though only 34.9% of the target sample size had been reached. The Z-cumulative curve for epidural or intrathecal administration did not cross the Trial Sequential Analysis monitoring boundary for benefit. No increase in adverse events was reported. CONCLUSIONS: Perioperative IV administration of magnesium effectively reduced shivering and Trial Sequential Analysis suggested that no more trials are required to confirm that IV magnesium effectively reduces shivering.

    DOI: 10.1213/ANE.0000000000004024

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  • 周術期がん患者の入院前待機時期の抑うつ状態と術後の抑うつ状態との関連 査読

    周藤美沙子, 伊吹愛, 中村幸代, 水原敬洋, 後藤隆久, 赤瀬智子

    臨床麻酔   43 ( 9 )   1233 - 1238   2019年9月

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    記述言語:日本語   出版者・発行元:真興交易(株)医書出版部  

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  • Desflurane impairs hippocampal learning on day 1 of exposure: A prospective laboratory study in rats

    Ayako Tojo, Kazuhiro Uchimoto, Gaku Inagawa, Takahisa Goto

    BMC Anesthesiology   19 ( 1 )   2019年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BioMed Central Ltd.  

    DOI: 10.1186/s12871-019-0793-8

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  • 長時間腹部手術後の手術部位感染症(SSI)と吸入麻酔薬使用との関連

    長嶺 祐介, 山本 さおり, 宮下 徹也, 後藤 隆久

    日本手術医学会誌   40 ( Suppl. )   144 - 144   2019年7月

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    記述言語:日本語   出版者・発行元:日本手術医学会  

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  • Necrosis Rather Than Apoptosis is The Dominant form of Alveolar Epithelial Cell Death In Lipopolysaccharide-Induced Experimental Acute Respiratory Distress Syndrome Model. 査読 国際誌

    Tamada N, Tojo K, Yazawa T, Goto T

    Shock   54 ( 1 )   128 - 139   2019年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/SHK.0000000000001425

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  • Comparison of the clinical performance of i-gel and Ambu AuraGain in children: A randomised noninferiority clinical trial. 査読 国際誌

    Takahiro Mihara, Rika Nakayama, Koui Ka, Takahisa Goto

    European journal of anaesthesiology   36 ( 6 )   411 - 417   2019年6月

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    記述言語:英語  

    BACKGROUND: Supraglottic airway devices are commonly used in general anaesthesia in children. The AuraGain is a newly developed disposable second-generation supraglottic airway device with an inflatable cuff and a gastric port. OBJECTIVE: To confirm our hypothesis that the oropharyngeal leak pressure (OLP) of the AuraGain would be noninferior to that of the i-gel in paediatric patients. DESIGN: A single-blinded, randomised, noninferiority, clinical trial. SETTING: Single-centre trial from January to March 2017. PATIENTS: One hundred paediatric patients (American Society of Anesthesiologists' physical status 1 to 3), aged up to 12 years old, and body weight of 5 to 30 kg requiring a supraglottic airway for elective surgery with an expected surgery time of less than 2 h under general anaesthesia. INTERVENTION: The patients were randomised to allocation to the AuraGain group or the i-gel group. The device size (1.5 to 2.5) used in each group was based on the manufacturer's recommendation. MAIN OUTCOME MEASURES: The primary outcome measure was OLP immediately after insertion, with a predefined noninferiority margin of 3 cmH2O. RESULTS: The OLP immediately after insertion was lower for the AuraGain than for the i-gel (17.1 vs. 23.0 cmH2O; mean difference: -5.9 cmH2O; 95% confidence interval: -8.5 to -3.3 cmH2O; P = 0.98 and <0.001 for noninferiority and superiority, respectively). The first-attempt success rate (AuraGain, 96% vs. i-gel, 90%; P = 0.44) was comparable between the devices. The incidence of blood staining was lower (AuraGain, 6% vs. i-gel, 0%; P = 0.012) and time to insertion was shorter (AuraGain 21.3 vs. i-gel, 17.1 s; P < 0.001) for the i-gel compared with the AuraGain. CONCLUSION: Our noninferiority hypothesis was not adopted. The OLP of the i-gel may be higher than that of the AuraGain, but this superiority hypothesis should be investigated in future trials. The i-gel demonstrated a shorter time to successful placement and lower incidence of blood staining than the AuraGain. TRIAL REGISTRATION: University Hospital Medical Information Network identifier, UMIN000024222.

    DOI: 10.1097/EJA.0000000000000987

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  • Effects of vasopressin during a pulmonary hypertensive crisis induced by acute hypoxia in a rat model of pulmonary hypertension. 査読

    Sugawara Y, Mizuno Y, Oku S, Goto T

    British journal of anaesthesia   122 ( 4 )   437 - 447   2019年4月

  • 麻酔看護の日米国際交流 査読

    大山亜希子, 他谷真遵, 井出悠紀子, 槇原弘子, 伊吹愛, 後藤隆久, 叶谷由佳, 赤瀬智子

    横浜看護学雑誌   12 ( 1 )   42 - 47   2019年3月

  • Effect of posterior quadratus lumborum blockade on the quality of recovery after major gynaecological laparoscopic surgery: A randomized controlled trial. 査読 国際誌

    Hiroko Fujimoto, Tomoya Irie, Takahiro Mihara, Yusuke Mizuno, Takeshi Nomura, Takahisa Goto

    Anaesthesia and intensive care   47 ( 2 )   146 - 151   2019年3月

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    記述言語:英語  

    Bilateral quadratus lumborum blockade (QLB) using ultrasound guidance has been introduced as an abdominal truncal block to improve postoperative analgesia and quality of recovery (QoR) after abdominal surgery, but efficacy remains controversial. The primary aim of this study was to evaluate the efficacy of posterior QLB on the postoperative QoR, and secondarily to evaluate postoperative pain after gynaecological laparoscopic surgery (LS). This study was a single-centre randomized controlled trial. QLB group patients underwent bilateral posterior quadratus lumborum injections with 25-30 mL of 0.25% levobupivacaine after induction of general anaesthesia; the control group underwent no block. Both groups were administered fentanyl-based intravenous patient-controlled analgesia postoperatively. The postoperative QoR was measured using the Quality of Recovery 40 (QoR-40) questionnaire score; postoperative pain was evaluated using the visual analogue scale (VAS) and the cumulative postoperative fentanyl dose. Thirty-one and 29 patients were randomised to the QLB and control groups, respectively. The intraoperative remifentanil dosage was significantly less in the QLB group. The median (interquartile range) for the QoR-40 score was not different between the groups: 154 (133-168) in the QLB group and 158 (144-172) in the control group. There were no statistically significant differences in secondary outcome variables. Single-shot QLB did not improve the QoR or postoperative pain in patients managed by multimodal analgesia after gynaecological LS.

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  • Simulation of pressure support for spontaneous breathing trials in neonates. 国際誌

    Makoto Sasaki, Yoshikazu Yamaguchi, Tetsuya Miyashita, Yuko Matsuda, Masahide Ohtsuka, Osamu Yamaguchi, Takahisa Goto

    Intensive care medicine experimental   7 ( 1 )   10 - 10   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Endotracheal tubes used for neonates are not as resistant to breathing as originally anticipated; therefore, spontaneous breathing trials (SBTs) with continuous positive airway pressure (CPAP), without pressure support (PS), are recommended. However, PS extubation criteria have predetermined pressure values for each endotracheal tube diameter (PS 10 cmH2O with 3.0- and 3.5-mm tubes or PS 8 cmH2O with 4.0-mm tubes). This study aimed to assess the validity of these SBT criteria for neonates, using an artificial lung simulator, ASL 5000™ lung simulator, and a SERVO-i Universal™ ventilator (minute volume, 240-360 mL/kg/min; tidal volume, 30 mL; respiratory rate, 24-36/min; lung compliance, 0.5 mL/cmH2O/kg; resistance, 40 cmH2O/L/s) in an intensive care unit. We simulated a spontaneous breathing test in a 3-kg neonate after cardiac surgery with 3.0-3.5-mm endotracheal tubes. We measured the work of breathing (WOB), trigger work, and parameters of pressure support ventilation (PSV), T-piece breathing, or ASL 5000™ alone. RESULTS: WOB displayed respiratory rate dependency under intubation. PS compensating tube resistance fluctuated with respiratory rate. At a respiratory rate of 24/min, the endotracheal tube did not greatly influence WOB under PSV and the regression line of WOB converged with the WOB of ASL 5000™ alone under PS 1 cmH2O; however, at 36/min, endotracheal tube was resistant to breathing under PSV because trigger work increased exponentially with PS ≤ 9 cmH2O. The regression line of WOB under PSV converged with the WOB of T-piece breathing under PS 1 cmH2O. Furthermore, PS compensating endotracheal tube resistance was 6 cmH2O. The WOB of ASL 5000™ alone approached that of respiratory distress syndrome (RDS); however, the pressure of patient effort was normal physiological range at PS 10 cmH2O. PS equalizing WOB under PSV with that after extubation depended on the respiratory rate and upper airway resistance. If WOB after extubation equaled that of T-piece breathing, the PS was 0 cmH2O regardless of the respiratory rates. If WOB after extubation approximated  to that of ASL 5000™ alone, the PS depended on the respiratory rate. CONCLUSION: SBT strategies should be selected per neonatal respiratory rates and upper airway resistance.

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  • Effectiveness of Magnesium in Preventing Shivering in Surgical Patients: A Systematic Review and Meta-analysis. 査読

    Kawakami H, Nakajima D, Mihara T, Sato H, Goto T

    Anesthesia and analgesia   2019年2月

  • The perfusion index measured by the pulse oximeter affects the agreement between ClearSight and the arterial catheter-based blood pressures: A prospective observational study. 査読 国際誌

    Masashi Yokose, Takahiro Mihara, Masahiro Takaya, Takumi Yamamoto, Yusuke Saigusa, Shunsuke Takaki, Takahisa Goto

    PloS one   14 ( 7 )   e0219511   2019年

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    記述言語:英語  

    BACKGROUND: ClearSight is a noninvasive arterial blood pressure monitor, but it remains unknown whether it is affected by the state of perfusion to the fingers. We investigated whether the lower perfusion index (PI) measured with a pulse oximeter, which reflects finger perfusion, would affect the agreement between arterial pressures measured with ClearSight versus those obtained with an arterial catheter. METHODS: Paired arterial pressure data (ClearSight and arterial catheter-based pressures) and PI values were prospectively obtained from 30 patients undergoing major abdominal surgery. The primary outcome was standard deviation (SD) of the bias (precision) of blood pressure between ClearSight and arterial catheter. The ratio of the adjusted SD of the bias between PI≤1 and PI>1 was calculated using the linear mixed-effects model. The secondary outcomes were the bias and the limits of agreement (LOA) between the two devices (repeated measures Bland-Altman analysis). RESULTS: We analyzed 6312 paired data points. The adjusted SD of bias in PI ≤1 compared with those in PI >1 was 1.4-fold (95% confidence interval: 1.3- to 1.4-fold) for systolic arterial pressure, 1.5-fold (95% confidence interval: 1.3- to 1.6-fold) for diastolic arterial pressure, and 1.3-fold (95% confidence interval: 1.2- to 1.5-fold) for mean arterial pressure. The bias (LOA) were as follows: systolic arterial pressure in the PI ≤1 and PI >1 groups, -3.5 (-35.4 to 28.4) mmHg and 2.2 (-19.9 to 24.3) mmHg, respectively; diastolic arterial pressure in the PI ≤1 and PI >1 groups, 13.1 (-5.1 to 31.3) mmHg and 9.0, (-2.6 to 20.6) mmHg, respectively; and mean arterial pressure in the PI ≤1 and PI >1 groups, 8.7 (-11.3 to 28.7) mmHg and 7.6 (-6.2 to 21.3) mmHg, respectively. CONCLUSIONS: PI ≤1 was associated with a large SD of the bias between the devices. The PI value could be a real-time indicator of ClearSight precision.

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  • Anesthetic management for resection of retroperitoneal massive paraganglioma (extra-adrenal pheochromocytoma): A case report

    Shoko Shkata, Yuriko Kondo, Tomoko Irisawa, Yusuke Nagamine, Yusuke Mizuno, Takahisa Goto

    Japanese Journal of Anesthesiology   67 ( 12 )   1309 - 1312   2018年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Kokuseido Publishing Co. Ltd  

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  • 後腹膜原発の巨大パラガングリオーマ(副腎外褐色細胞腫)摘出術の麻酔管理の1症例

    白田 祥子, 近藤 有理子, 入澤 朋子, 長嶺 祐介, 水野 祐介, 後藤 隆久

    麻酔   67 ( 12 )   1309 - 1312   2018年12月

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    記述言語:日本語   出版者・発行元:克誠堂出版(株)  

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  • Driving-pressure-independent protective effects of open lung approach against experimental acute respiratory distress syndrome. 査読 国際誌

    Tojo K, Yoshida T, Yazawa T, Goto T

    Critical Care   22 ( 1 )   228 - 228   2018年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/s13054-018-2154-2

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  • Relationship between fresh frozen plasma to packed red blood cell transfusion ratio and mortality in cardiovascular surgery.

    Akito Tsukinaga, Takuma Maeda, Shunsuke Takaki, Nobuaki Michihata, Yoshihiko Ohnishi, Takahisa Goto

    Journal of anesthesia   32 ( 4 )   539 - 546   2018年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: The aim of this study was to examine the relationship between FFP (fresh frozen plasma)/pRBC (packed red blood cell) transfusion ratio and outcomes in patients undergoing cardiovascular surgery. METHODS: This is a single center retrospective cohort study performed in a cardiovascular center. Patients undergoing cardiovascular surgery between January 2012 and October 2016 with or without massive transfusion (n = 1453). Patients' outcomes were compared based on FFP/pRBC transfusion ratio (FFP/pRBC > 1 or FFP/pRBC ≤ 1). RESULTS: In hospital mortality and rate of stroke and myocardial infarction was significantly higher in patients with less than 1 of FFP/pRBC transfusion ratio only in patients with massive transfusion (3.0 vs 8.8%, p = 0.001; 0.7 vs 6.4%, p < 0.001; 1.0 vs 3.2%, p = 0.047, respectively). CONCLUSIONS: Higher FFP/RBC ratio was associated with reduced risk of death, stroke and myocardial infarction only in patients with cardiovascular surgery receiving massive transfusion. Clinicians should be aware that judicious FFP replacement plays a critical role in the successful management of massive transfusion in cardiac surgery.

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  • Does fentanyl or remifentanil provide better postoperative recovery after laparoscopic surgery? a randomized controlled trial. 査読 国際誌

    Ayako Asakura, Takahiro Mihara, Takahisa Goto

    BMC anesthesiology   18 ( 1 )   81 - 81   2018年7月

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    記述言語:英語  

    BACKGROUND: Fentanyl and remifentanil are widely used opioids in surgery, but it has not been evaluated whether the choice of opioids during surgery affects the patients' postoperative quality of recovery. Accordingly, we aim to compare postoperative recovery of fentanyl-based anesthesia with remifentanil-based anesthesia after laparoscopic surgery using the QoR 40 questionnaire (QoR-40). METHODS: The study was prospective, randomized, patient and investigator-blinded, controlled, clinical trial. Seventy patients undergoing laparoscopic or retroperitoneoscopic renal or ureteral surgery were recruited and randomized to either fentanyl or remifentanil based anesthesia groups. The primary outcome was the global QoR-40 at 24 h after surgery. RESULTS: The global median (interquartile range) QoR-40 score was 160 (138-177) in the fentanyl group (n = 32) and 140 (127-166) in the remifentanil group (n = 31). Physical comfort and physical independence, the two out of the five dimensions of the QoR-40, demonstrated significantly high scores in the fentanyl group (P = 0.047 and P = 0.032, respectively). CONCLUSION: Although the global QoR is higher in the fentanyl group by 20 points compared with remifentanil group, no significant differences revealed between the groups. Further studies with large numbers of subjects of the same gender are needed. TRIAL REGISTRATION: University Hospital Medical Information Network (UMIN),  UMIN000010464 . Registered 10 April 2013.

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  • A case of awake craniotomy converted to general anesthesia because of insufficient emergence during operation

    Yuko Matsuda, Yumi Saishu, Yusuke Mizuno, Takahisa Goto

    Japanese Journal of Anesthesiology   67 ( 7 )   748 - 751   2018年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Kokuseido Publishing Co. Ltd  

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  • 十分な覚醒が得られず、覚醒下開頭腫瘍摘出術を断念した1症例

    松田 優子, 西周 祐美, 水野 祐介, 後藤 隆久

    麻酔   67 ( 7 )   748 - 751   2018年7月

  • Avoidance of general anesthesia by employing pecs block: A case of breast cancer and interstitial pneumonia

    Natsuhiro Yamamoto, Yusuke Mizuno, Takeshi Nomura, Takahisa Goto

    Japanese Journal of Anesthesiology   67 ( 6 )   611 - 613   2018年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Kokuseido Publishing Co. Ltd  

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  • pectoral nerve blockのみで乳房部分切除手術を管理しえた1症例

    山本 夏啓, 水野 祐介, 野村 岳志, 後藤 隆久

    麻酔   67 ( 6 )   611 - 613   2018年6月

  • Predictors of severe postoperative hyperglycemia after cardiac surgery in infants: a single-center, retrospective, observational study 査読

    Natsuhiro Yamamoto, Tomoya Irie, Shunsuke Takaki, Osamu Yamaguchi, Takahisa Goto

    Journal of Anesthesia   32 ( 2 )   160 - 166   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Tokyo  

    DOI: 10.1007/s00540-017-2444-x

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  • Enhancement of glycolysis by inhibition of oxygen-sensing prolyl hydroxylases protects alveolar epithelial cells from acute lung injury. 査読 国際誌

    Kentaro Tojo, Nao Tamada, Yusuke Nagamine, Takuya Yazawa, Shuhei Ota, Takahisa Goto

    FASEB journal : official publication of the Federation of American Societies for Experimental Biology   32 ( 4 )   2258 - 2268   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Cellular bioenergetic failure caused by mitochondrial dysfunction is a key process of alveolar epithelial injury during acute respiratory distress syndrome (ARDS). Prolyl hydroxylases (PHDs) act as cellular oxygen sensors, and their inhibition activates hypoxia-inducible factor (HIF), resulting in enhanced cellular glycolytic activity, which could compensate for impaired mitochondrial function and protect alveolar epithelial cells from ARDS. Here, we evaluated the effects of pharmacological PHD inhibition with dimethyloxalylglycine (DMOG) on alveolar epithelial cell injury using in vitro and in vivo ARDS models. We established an in vitro model of alveolar epithelial injury mimicking ARDS by adding isolated neutrophils and LPS to cultured MLE12 alveolar epithelial cells. DMOG treatment protected MLE12 cells from neutrophil-LPS-induced ATP decline and cell death. Knockdown of HIF-1α or inhibition of glycolysis abolished the protective effect of DMOG, suggesting that it was exerted by HIF-1-dependent enhancement of glycolysis. Additionally, intratracheal DMOG administration to mice protected the alveolar epithelial barrier and improved arterial oxygenation, preventing ATP decline during LPS-induced lung injury. In summary, enhancement of glycolysis by PHD inhibition is a potential therapeutic approach for ARDS, protecting alveolar epithelial cells from bioenergetic failure and cell death.- Tojo, K., Tamada, N., Nagamine, Y., Yazawa, T., Ota, S., Goto, T. Enhancement of glycolysis by inhibition of oxygen-sensing prolyl hydroxylases protects alveolar epithelial cells from acute lung injury. FASEB J. 32, 2258-2268 (2018). www.fasebj.org.

    DOI: 10.1096/fj.201700888R

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  • Roles and mechanism of protein kinase D in vasoconstriction

    Yusuke Mizuno, Yoh Sugawara, Takahisa Goto

    FASEB JOURNAL   32 ( 1 )   2018年4月

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    記述言語:英語  

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  • PI値はClearSightによる心拍出量測定の正確性の指標となるか?

    横瀬 真志, 早川 翔, 田中 宏幸, 濱田 貴子, 吉田 輔, 高木 俊介, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   25 ( Suppl. )   [O72 - 5]   2018年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • Successful assessment of vocal cord palsy before tracheal extubation by laryngeal ultrasonography in a patient after esophageal surgery: A case report

    Natsuhiro Yamamoto, Yoshikazu Yamaguchi, Takeshi Nomura, Osamu Yamaguchi, Takahisa Goto

    100 Selected Case Reports from Anesthesia and Analgesia   2018年1月

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    記述言語:英語   掲載種別:論文集(書籍)内論文   出版者・発行元:Wolters Kluwer Health  

    DOI: 10.1213/XAA.0000000000000601

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  • Enhancement of glycolysis by inhibition of oxygen-sensing prolyl hydroxylases protects alveolar epithelial cells from acute lung injury. 査読

    後藤 隆久

    FASEB Journal   fj201700888R   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1096/fj.201700888R

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  • Comparison between High- and Low-Cost Transmission of Tele-Anesthesia in Japan. 査読

    Sugawara Y, Miyashita T, Mizuno Y, Nagamine Y, Miyazaki T, Kobayashi A, Tojo K, Iketani Y, Takaki S, Goto T

    Journal of healthcare engineering   2018   9615264   2018年

  • Unilateral electrical stimulation of the heart 7 acupuncture point to prevent emergence agitation in children: A prospective, double-blinded, randomized clinical trial. 査読 国際誌

    Nobuhito Nakamura, Takahiro Mihara, Toshiyuki Hijikata, Takahisa Goto, Koui Ka

    PloS one   13 ( 10 )   e0204533   2018年

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    記述言語:英語  

    BACKGROUND: Emergence agitation (EA) is a frequent phenomenon in children recovering from general anaesthesia and increases the risk of self-injury. Previously, our group reported that stimulating the heart 7 (HT7) acupuncture point bilaterally using two neuromuscular transmission monitoring devices (NTMs) decreased the incidence of EA. However, bilateral stimulation is a barrier to clinical use because two NTMs are needed for one patient. OBJECTIVE: The objective of this study was to examine the efficacy of unilateral electrical stimulation of HT7 using an NTM to prevent EA in children. DESIGN: Prospective, double-blinded, randomized clinical trial. SETTING: Kanagawa Children's Medical Centre, Yokohama, Japan. PATIENTS: One hundred children (ages 18-96 months) with ASA-PS I or II, who were scheduled to undergo inguinal hernia repair or orchiopexy under sevoflurane anaesthesia. INTERVENTION: Patients were randomly assigned to one of the following two groups: (1) HT7 group: unilateral (right side) stimulation of the HT7 acupuncture point using a single-twitch electrical stimulus (1 Hz, 50 mA) throughout the surgery, and (2) control group: electrodes alone were attached to the HT7 point on the right side; an electrical stimulus was not applied. MAIN OUTCOME MEASURES: The primary outcome was the incidence of EA evaluated using the pediatric anaesthesia emergence delirium (PAED) scale. The secondary outcomes were the incidence of EA evaluated using Aono's scale, the severity of EA, PACU stay duration, and postoperative pain. RESULTS: There was no statistical difference between the incidence of EA in the HT7 and the control group (28.0% and 24.0%, respectively; P > 0.99). The risk ratio was 1.17 (95% confidence interval: 0.60-2.27). CONCLUSIONS: We observed that there was no effect of unilateral single-twitch electrical stimulation to the HT7 on the incidence of EA, contrary to the findings with bilateral HT7 stimulation.

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  • Efficacy of continuous versus intermittent subglottic secretion drainage in preventing ventilator-associated pneumonia in patients requiring mechanical ventilation: A single-center randomized controlled trial 査読

    Hiroko Fujimoto, Osamu Yamaguchi, Hajime Hayami, Mika Shimosaka, Sayaka Tsuboi, Mitsunori Sato, Shigeo Takebayashi, Satoshi Morita, Mari Saito, Takahisa Goto, Kiyoyasu Kurahashi

    Oncotarget   9 ( 22 )   15876 - 15882   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Impact Journals LLC  

    DOI: 10.18632/oncotarget.24630

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  • Effect of magnesium added to local anesthetics for caudal anesthesia on postoperative pain in pediatric surgical patients: A systematic review and meta-analysis with Trial Sequential Analysis. 査読 国際誌

    Hiromasa Kawakami, Takahiro Mihara, Nobuhito Nakamura, Koui Ka, Takahisa Goto

    PloS one   13 ( 1 )   e0190354   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Magnesium has been investigated as an adjuvant for neuraxial anesthesia, but the effect of caudal magnesium on postoperative pain is inconsistent. The aim of this systematic review and meta-analysis was to evaluate the analgesic effect of caudal magnesium. METHODS: We searched six databases, including trial registration sites. Randomized clinical trials reporting the effect of caudal magnesium on postoperative pain after general anesthesia were eligible. The risk ratio for use of rescue analgesics after surgery was combined using a random-effects model. We also assessed adverse events. The I2 statistic was used to assess heterogeneity. We assessed risk of bias with Cochrane domains. We controlled type I and II errors due to sparse data and repetitive testing with Trial Sequential Analysis. We assessed the quality of evidence with GRADE. RESULTS: Four randomized controlled trials (247 patients) evaluated the need for rescue analgesics. In all four trials, 50 mg of magnesium was administered with caudal ropivacaine. The results suggested that the need for rescue analgesia was reduced significantly by caudal magnesium administration (risk ratio 0.45; 95% confidence interval 0.24-0.86). There was considerable heterogeneity as indicated by an I2 value of 62.5%. The Trial Sequential Analysis-adjusted confidence interval was 0.04-5.55, indicating that further trials are required. The quality of evidence was very low. The rate of adverse events was comparable between treatment groups. CONCLUSION: Caudal magnesium may reduce the need for rescue analgesia after surgery, but further randomized clinical trials with a low risk of bias and a low risk of random errors are necessary to assess the effect of caudal magnesium on postoperative pain and adverse events. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry UMIN000025344.

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  • Effect of an Intravenous Dexamethasone Added to Caudal Local Anesthetics to Improve Postoperative Pain: A Systematic Review and Meta-analysis With Trial Sequential Analysis 査読

    Hiromasa Kawakami, Takahiro Mihara, Nobuhito Nakamura, Koui Ka, Takahisa Goto

    ANESTHESIA AND ANALGESIA   125 ( 6 )   2072 - 2080   2017年12月

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  • Behavior of Anesthesiology Residents in a Situation of Intravenous Route Occlusion During Syringe Pump Use in a Simulated Intensive Care Unit. 査読 国際誌

    Kariya T, Miyashita T, Sato H, Kawakami H, Goto T

    Journal of patient safety   15 ( 4 )   290 - 292   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/PTS.0000000000000232

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  • Comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting: An updated systematic review and meta-analysis with trial sequential analysis 査読

    Ayako Yokoi, Takahiro Mihara, Koui Ka, Takahisa Goto

    PLOS ONE   12 ( 10 )   e0186006   2017年10月

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  • A network meta-analysis of the clinical properties of various types of supraglottic airway device in children 査読

    T. Mihara, A. Asakura, G. Owada, A. Yokoi, K. Ka, T. Goto

    ANAESTHESIA   72 ( 10 )   1251 - 1264   2017年10月

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  • Hyperleukocytosis Complicated by Intracerebral Hemorrhage and Spurious Hypoxemia: A Case Report and Literature Review. 国際誌

    Yumi Katakura, Yoshikazu Yamaguchi, Tetsuya Miyashita, Masafumi Idei, Tasuku Yoshida, Yuko Matsuda, Shunsuke Takaki, Aki Kamijo, Osamu Yamaguchi, Takahisa Goto

    A & A case reports   9 ( 6 )   159 - 161   2017年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We present the management of a 15-year-old girl with acute myeloid leukemia who presented with massive hyperleukocytosis and neurological deficit due to intracerebral hemorrhage. Surgical intervention was considered but ultimately not undertaken because of the presence of massive hyperleukocytosis, thrombocytopenia, hypokalemia, and considerable discrepancy between the oxygen saturation values determined mechanically and by peripheral oximetry. Aggressive treatment of the hyperleukocytosis was immediately started, which improved the patient's overall condition and rendered surgical intervention unnecessary. This report shows that immediate treatment of massive hyperleukocytosis and critical interpretation of laboratory results in patients with hyperleukocytosis are warranted.

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  • CO2ナルコーシスを呈した肥満低換気症候群の患者を非侵襲的陽圧換気で管理した1例

    吉田 輔, 山口 嘉一, 松田 優子, 高木 俊介, 山口 修, 後藤 隆久

    臨床麻酔   41 ( 8 )   1157 - 1159   2017年8月

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    記述言語:日本語   出版者・発行元:真興交易(株)医書出版部  

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  • Development and Validation of a Risk Scale for Emergence Agitation After General Anesthesia in Children: A Prospective Observational Study 査読

    Maai Hino, Takahiro Mihara, Saeko Miyazaki, Toshiyuki Hijikata, Takaaki Miwa, Takahisa Goto, Koui Ka

    ANESTHESIA AND ANALGESIA   125 ( 2 )   550 - 555   2017年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1213/ANE.0000000000002126

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  • Adenovirus vector expressing keratinocyte growth factor using CAG promoter impairs pulmonary function of mice with elastase-induced emphysema 査読

    Hiroshi Oki, Takuya Yazawa, Yasuko Baba, Yumi Kanegae, Hanako Sato, Seiko Sakamoto, Takahisa Goto, Izumu Saito, Kiyoyasu Kurahashi

    MICROBIOLOGY AND IMMUNOLOGY   61 ( 7 )   264 - 271   2017年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/1348-0421.12492

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  • Mechanisms of POD and POCD: Effects of anesthetics 査読

    Tomoyuki Miyazaki, Yoshikazu Yamaguchi, Takahisa Goto

    Anesthesia and Neurotoxicity   133 - 150   2017年5月

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    記述言語:英語   掲載種別:論文集(書籍)内論文   出版者・発行元:Springer Japan  

    DOI: 10.1007/978-4-431-55624-4_9

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  • A comparison of the Airtraq®, McGrath®, and Macintosh laryngoscopes for difficult paediatric intubation: A manikin study. 査読

    Owada G, Mihara T, Inagawa G, Asakura A, Goto T, Ka K

    PloS one   12 ( 2 )   e0171889   2017年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1371/journal.pone.0171889

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  • Consequences of not relieving negative internal pressure of a medication vial: A survey and simulation study 査読

    Hiroko Fujimoto, Tomoya Irie, Hiromasa Kawakami, Tetsuya Miyashita, Takahisa Goto

    JOURNAL OF CLINICAL ANESTHESIA   37   168 - 172   2017年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.jclinane.2016.12.002

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  • Prevention of Burn-Induced Inflammatory Responses and Muscle Wasting By GTS-21, A Specific Agonist for α7 Nicotinic Acetylcholine Receptors 査読

    47 ( 1 )   61 - 69   2017年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/SHK.0000000000000729

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  • Deep Breathing Improves End-Tidal Carbon Dioxide Monitoring of an Oxygen Nasal Cannula-Based Capnometry Device in Subjects Extubated After Abdominal Surgery 査読

    Shunsuke Takaki, Kenji Mizutani, Moeka Fukuchi, Tasuku Yoshida, Masahumi Idei, Yuko Matsuda, Yoshikazu Yamaguchi, Tetsuya Miyashita, Takeshi Nomura, Osamu Yamaguchi, Takahisa Goto

    RESPIRATORY CARE   62 ( 1 )   86 - 91   2017年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.4187/respcare.04634

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  • Inhibition of Prolyl Hydroxylase Attenuates Fas Ligand-Induced Apoptosis and Lung Injury in Mice 査読

    Yusuke Nagamine, Kentaro Tojo, Takuya Yazawa, Shunsuke Takaki, Yasuko Baba, Takahisa Goto, Kiyoyasu Kurahashi

    AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY   55 ( 6 )   878 - 888   2016年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER THORACIC SOC  

    Alveolar epithelial injury and increased alveolar permeability are hallmarks of acute respiratory distress syndrome. Apoptosis of lung epithelial cells via the Fas/Fas ligand (FasL) pathway plays a critical role in alveolar epithelial injury. Activation of hypoxiainducible factor (HIF)-1 by inhibition of prolyl hydroxylase domain proteins (PHDs) is a possible therapeutic approach to attenuate apoptosis and organ injury. Here, we investigated whether treatment with dimethyloxalylglycine (DMOG), an inhibitor of PHDs, could attenuate Fas/FasL-dependent apoptosis in lung epithelial cells and lung injury. DMOG increased HIF-1 alpha protein expression in vitro in MLE-12 cells, a murine alveolar epithelial cell line. Treatment of MLE-12 cells with DMOG significantly suppressed cell surface expression of Fas and attenuated FasL-induced caspase-3 activation and apoptotic cell death. Inhibition of the HIF-1 pathway by echinomycin or small interfering RNA transfection abolished these antiapoptotic effects of DMOG. Moreover, intraperitoneal injection of DMOG in mice increased HIF-1a expression and decreased Fas expression in lung tissues. DMOG treatment significantly attenuated caspase-3 activation, apoptotic cell death in lung tissue, and the increase in alveolar permeability in mice instilled intratracheally with FasL. In addition, inflammatory responses and histopathological changes were also significantly attenuated by DMOG treatment. In conclusion, inhibition of PHDs protects lung epithelial cells from Fas/FasL-dependent apoptosis through HIF-1 activation and attenuates lung injury in mice.

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  • Protective effects of continuous positive airway pressure on a nonventilated lung during one-lung ventilation: A prospective laboratory study in rats. 査読

    Tojo K, Goto T, Kurahashi K, European journal of anaesthesiology

    33 ( 10 )   776 - 783   2016年10月

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    Tojo K, Goto T, Kurahashi K, European journal of anaesthesiology, 2016, vol. 33, no. 10, pp. 776-783, 2016

    DOI: 10.1097/EJA.0000000000000460

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    その他リンク: http://orcid.org/0000-0002-1194-8636

  • Bumetanide, an Inhibitor of NKCC1 (Na-K-2Cl Cotransporter Isoform 1), Enhances Propofol-Induced Loss of Righting Reflex but Not Its Immobilizing Actions in Neonatal Rats 査読

    Yukihide Koyama, Tomio Andoh, Yoshinori Kamiya, Tomoyuki Miyazaki, Koichi Maruyama, Takayuki Kariya, Takahisa Goto

    PLOS ONE   11 ( 10 )   e0164125   2016年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1371/journal.pone.0164125

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  • Effects of Steroids on Quality of Recovery and Adverse Events after General Anesthesia: Meta-Analysis and Trial Sequential Analysis of Randomized Clinical Trials 査読

    Takahiro Mihara, Tomoko Ishii, Koui Ka, Takahisa Goto

    PLOS ONE   11 ( 9 )   e0162961   2016年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1371/journal.pone.0162961

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  • Electrical stimulation of the heart 7 acupuncture site for preventing emergence agitation in children A randomised controlled trial 査読

    Toshiyuki Hijikata, Takahiro Mihara, Nobuhito Nakamura, Takaaki Miwa, Koui Ka, Takahisa Goto

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY   33 ( 7 )   535 - 542   2016年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/EJA.0000000000000379

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  • Low tidal volume ventilation with low PEEP during surgery may induce lung inflammation 査読

    Hitoshi Sato, Kyota Nakamura, Yasuko Baba, Shoko Terada, Takahisa Goto, Kiyoyasu Kurahashi

    BMC ANESTHESIOLOGY   16   2016年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/s12871-016-0209-y

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  • [The Use of Arginine Vasopressin and PhosphodiesteraseIII Inhibitor for Circulatory Shock after the Resection of a Massive Adrenal Pheochromocytoma]. 査読

    Nagamine Y, Nishinarita R, Mizutani K, Goto T

    Masui. The Japanese journal of anesthesiology   65 ( 6 )   624 - 627   2016年6月

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  • [Involuntary Movement of Bilateral Lower Limbs Caused by Epidural Anesthesia: A Case Report]. 査読

    Toki K, Yokose M, Miyashita T, Sato H, Fujimoto H, Yamamoto S, Goto T

    Masui. The Japanese journal of anesthesiology   65 ( 6 )   628 - 631   2016年6月

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    記述言語:日本語   出版者・発行元:克誠堂出版  

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    その他リンク: http://search.jamas.or.jp/link/ui/2016318636

  • Effect of the McGRATH MAC® Video Laryngoscope on Hemodynamic Response during Tracheal Intubation: A Retrospective Study. 査読

    Yokose M, Mihara T, Kuwahara S, Goto T

    11 ( 5 )   2016年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1371/journal.pone.0155566

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  • Roles of protein kinase D in vasoconstriction and hemodynamics

    Yoh Sugawara, Yusuke Mizuno, Hiromasa Kawakami, Takahisa Goto

    FASEB JOURNAL   30   2016年4月

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    記述言語:英語  

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  • Difference in the spread of injectate between ultrasound guided pectoral nerve block I and II. A cadaver study 査読

    Masaru Kikuchi, Shunsuke Takaki, Takeshi Nomura, Takahisa Goto

    Japanese Journal of Anesthesiology   65 ( 3 )   314 - 317   2016年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Kokuseido Publishing Co. Ltd  

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  • Perioperative considerations in adult mitochondrial disease: A case series and a review of 111 cases 査読

    Yuri Miyamoto, Tetsuya Miyashita, Shunsuke Takaki, Takahisa Goto

    MITOCHONDRION   26   26 - 32   2016年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.mito.2015.11.004

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  • Influence of Mental Workload on the Performance of Anesthesiologists during Induction of General Anesthesia: A Patient Simulator Study 査読

    Hitoshi Sato, Tetsuya Miyashita, Hiromasa Kawakami, Yusuke Nagamine, Shunsuke Takaki, Takahisa Goto

    BIOMED RESEARCH INTERNATIONAL   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1155/2016/1058750

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  • Inhibition Of Prolyl Hydroxylase Attenuates Fas Ligand-Induced Apoptosis And Lung Injury In Mice 査読

    Y. Nagamine, K. Tojo, T. Yazawa, S. Takaki, Y. Baba, T. Goto, K. Kurahashi

    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE   193   2016年

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    記述言語:英語   出版者・発行元:AMER THORACIC SOC  

    DOI: 10.1165/rcmb.2015-0266OC

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  • Adrenaline aggravates lung injury caused by liver ischemia-reperfusion and high-tidal-volume ventilation in rats. 査読

    Ota S, Yazawa T, Tojo K, Baba Y, Uchiyama M, Goto T, Kurahashi K, Jo

    4   8   2016年

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    Ota S, Yazawa T, Tojo K, Baba Y, Uchiyama M, Goto T, Kurahashi K, Journal of intensive care, 2016, vol. 4, pp. 8, 2016

    DOI: 10.1186/s40560-016-0130-y

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  • Effects of melatonin premedication to prevent emergence agitation after general anaesthesia in children: A systematic review and meta-analysis with trial sequential analysis. 査読

    Mihara T, Nakamura N, Ka K, Oba MS, Goto T

    European journal of anaesthesiology   32 ( 12 )   862 - 871   2015年12月

  • Atelectasis causes alveolar hypoxia-induced inflammation during uneven mechanical ventilation in rats. 査読 国際誌

    Tojo K, Nagamine Y, Yazawa T, Mihara T, Baba Y, Ota S, Goto T, Kurahashi K

    Intensive care medicine experimental   3 ( 1 )   56 - 56   2015年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/s40635-015-0056-z

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  • The Effect of Preoperative Oral Carbohydrate or Oral Rehydration Solution on Postoperative Quality of Recovery: A Randomized, Controlled Clinical Trial

    Ayako Asakura, Takahiro Mihara, Takahisa Goto

    PLOS ONE   10 ( 8 )   2015年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1371/journal.pone.0133309

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  • Estrous Cycle-Dependent Phasic Changes in the Stoichiometry of Hippocampal Synaptic AMPA Receptors in Rats 査読

    Hirobumi Tada, Mayu Koide, Wakana Ara, Yusuke Shibata, Toshiya Funabashi, Kumiko Suyama, Takahisa Goto, Takuya Takahashi

    PLOS ONE   10 ( 6 )   2015年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Spinal cord stimulation modulates supraspinal centers of the descending antinociceptive system in rats with unilateral spinal nerve injury

    Toshiharu Tazawa, Yoshinori Kamiya, Ayako Kobayashi, Kensuke Saeki, Masahito Takiguchi, Yusuke Nakahashi, Hironobu Shinbori, Kengo Funakoshi, Takahisa Goto

    MOLECULAR PAIN   11   2015年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/s12990-015-0039-9

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  • Evaluation of an oxygen mask-based capnometry device in subjects extubated after abdominal surgery. 査読

    Takaki S, Mihara T, Mizutani K, Yamaguchi O, Goto T

    Respiratory care   60 ( 5 )   705 - 710   2015年5月

  • Edaravone prevents lung injury induced by hepatic ischemia-reperfusion. 査読

    Uchiyama M, Tojo K, Yazawa T, Ota S, Goto T, Kurahashi K

    The Journal of surgical research   194 ( 2 )   551 - 557   2015年4月

  • A pilot study of tele-anaesthesia by virtual private network between an island hospital and a mainland hospital in Japan. 査読

    Miyashita T, Mizuno Y, Sugawara Y, Nagamine Y, Koyama Y, Miyazaki T, Uchimoto K, Iketani Y, Tojo K, Goto T

    Journal of telemedicine and telecare   21 ( 2 )   73 - 79   2015年3月

  • Postanesthetic Effects of Isoflurane on Behavioral Phenotypes of Adult Male C57BL/6J Mice 査読

    Kumiko Yonezaki, Kazuhiro Uchimoto, Tomoyuki Miyazaki, Ayako Asakura, Ayako Kobayashi, Kenkichi Takase, Takahisa Goto

    PLOS ONE   10 ( 3 )   e0122118   2015年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Modified rapid shallow breathing index adjusted with anthropometric parameters increases predictive power for extubation failure compared with the unmodified index in postcardiac surgery patients. 査読

    Takaki S, Kadiman SB, Tahir SS, Ariff MH, Kurahashi K, Goto T

    Journal of cardiothoracic and vascular anesthesia   29 ( 1 )   64 - 68   2015年2月

  • Relationship between ventral lumbar disc protrusion and contrast medium leakage during sympathetic nerve block 査読

    Toshiharu Tazawa, Yoshinori Kamiya, Mina Takamori, Ken-ichi Ogawa, Takahisa Goto

    JOURNAL OF ANESTHESIA   29 ( 1 )   138 - 142   2015年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00540-014-1871-1

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  • Perioperative change in creatinine following cardiac surgery with cardiopulmonary bypass is useful in predicting acute kidney injury: A single-centre retrospective cohort study

    Shunsuke Takaki, Yahya Shehabi, John W. Pickering, Zoltan Endre, Tetsuya Miyashita, Takahisa Goto

    Interactive Cardiovascular and Thoracic Surgery   21   465 - 469   2015年1月

  • Percutaneous Transtracheal Jet Ventilation with Various Upper Airway Obstruction

    Tomoki Doi, Tetsuya Miyashita, Ryousuke Furuya, Hitoshi Sato, Shunsuke Takaki, Takahisa Goto

    BIOMED RESEARCH INTERNATIONAL   2015   2015年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1155/2015/454807

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  • The efficacy of lidocaine to prevent laryngospasm in children: a systematic review and meta-analysis 査読

    T. Mihara, K. Uchimoto, S. Morita, T. Goto

    ANAESTHESIA   69 ( 12 )   1388 - 1396   2014年12月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL  

    The purpose of this meta-analysis was to determine the efficacy of lidocaine in preventing laryngospasm during general anaesthesia in children. An electronic search of six databases was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were adhered to. We included randomised controlled trials reporting the effects of intravenous and/or topical lidocaine on the incidence of laryngospasm during general anaesthesia. Nine studies including 787 patients were analysed. The combined results demonstrated that lidocaine is effective in preventing laryngospasm (risk ratio (RR) 0.39, 95% CI 0.24-0.66; I-2=0). Subgroup analysis revealed that both intravenous lidocaine (RR 0.34, 95% CI 0.14-0.82) and topical lidocaine (RR 0.42, 95% CI 0.22-0.80) lidocaine are effective in preventing laryngospasm. The results were not affected by studies with a high risk of bias. We conclude that, both topical and intravenous lidocaine are effective for preventing laryngospasm in children.

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  • Direct measurement of a patient's entrance skin dose during pediatric cardiac catheterization. 国際誌

    Lue Sun, Yusuke Mizuno, Mari Iwamoto, Takahisa Goto, Yasuhiro Koguchi, Yuka Miyamoto, Koji Tsuboi, Koichi Chida, Takashi Moritake

    Journal of radiation research   55 ( 6 )   1122 - 30   2014年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1093/jrr/rru050

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  • Role of VPAC2 receptor in monocrotaline-induced pulmonary hypertension in rats 査読

    Motokazu Koga, Yusuke Mizuno, Itaru Watanabe, Hiromasa Kawakami, Takahisa Goto

    JOURNAL OF APPLIED PHYSIOLOGY   117 ( 4 )   383 - 391   2014年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1152/japplphysiol.00861.2013

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  • Effect of lidocaine on preventing laryngospasm during general anaesthesia in children: a systematic review and meta-analysis

    T. Mihara, Kazuhiro Uchimoto, T. Goto

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY   31   1 - 1   2014年6月

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    記述言語:英語   掲載種別:研究論文(その他学術会議資料等)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Very short exposure of volatile anesthetics induces long-term learning deficit in young adult male rats

    Kazuhiro Uchimoto, H. Fujimoto, K. Yonezaki, T. Miyazaki, T. Ando, T. Goto

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY   31   121 - 121   2014年6月

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    記述言語:英語   掲載種別:研究論文(その他学術会議資料等)  

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  • FaceTime(®) for teaching ultrasound-guided anesthetic procedures in remote place. 査読

    Miyashita T, Iketani Y, Nagamine Y, Goto T

    Journal of clinical monitoring and computing   28 ( 2 )   211 - 215   2014年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Role of nerve growth factor-tyrosine kinase receptor A signaling in paclitaxel-induced peripheral neuropathy in rats. 査読

    Nakahashi Y, Kamiya Y, Funakoshi K, Miyazaki T, Uchimoto K, Tojo K, Ogawa K, Fukuoka T, Goto T

    Biochemical and biophysical research communications   444 ( 3 )   415 - 419   2014年2月

  • [Usefulness of ultrasound pre-scanning for cricothyroid membrane puncture in a patient with rupture of a pseudoaneurysm]. 査読

    Owada G, Inagawa G, Nakamura K, Kariya T, Goto T

    Masui. The Japanese journal of anesthesiology   63 ( 1 )   77 - 80   2014年1月

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    記述言語:日本語   出版者・発行元:克誠堂出版  

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    その他リンク: http://search.jamas.or.jp/link/ui/2014121636

  • Isoflurane Impairs Learning and Hippocampal Long-term Potentiation via the Saturation of Synaptic Plasticity 査読 国際誌

    Kazuhiro Uchimoto, Tomoyuki Miyazaki, Yoshinori Kamiya, Takahiro Mihara, Yukihide Koyama, Masataka Taguri, Gaku Inagawa, Takuya Takahashi, Takahisa Goto

    Anesthesiology   121 ( 2 )   302 - 10   2014年

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    DOI: 10.1097/ALN.0000000000000269

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  • Phasic synaptic incorporation of GluR2-lacking AMPA receptors at gonadotropin-releasing hormone neurons is involved in the generation of the luteinizing hormone surge in female rats 査読

    H. Tada, Y. Kuroki, T. Funabashi, Y. Kamiya, T. Goto, K. Suyama, A. Sano, D. Mitsushima, A. M. Etgen, T. Takahashi

    Neuroscience   248   664 - 669   2013年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.neuroscience.2013.06.040

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  • Trans-resectoscope stimulation predicts the need to block adductor response during bladder tumor resection. 査読

    Mihara T, Itoh H, Hashimoto K, Goto T

    Anesthesia and analgesia   117 ( 3 )   740 - 744   2013年9月

  • 小児心カテーテル術中の患者の入射皮膚線量の直接測定法(Direct measurement of patient's entrance skin dose during pediatric cardiac catheterization)

    孫 略, 水野 祐介, 岩本 眞理, 後藤 隆久, 小口 靖弘, 坪井 康次, 千田 浩一, 盛武 敬

    日本放射線技術学会雑誌   69 ( 9 )   1070 - 1070   2013年9月

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  • Reevaluation of the effectiveness of ramosetron for preventing postoperative nausea and vomiting: a systematic review and meta-analysis. 査読

    Mihara T, Tojo K, Uchimoto K, Morita S, Goto T

    Anesthesia and analgesia   117 ( 2 )   329 - 339   2013年8月

  • Effect of VPAC2 agonist on improving cardiac output in pulmonary hypertension 査読

    Mizuno Yusuke, Koga Motokazu, Kashiwagi Shizuka, Watanabe Itaru, Goto Takahisa

    FASEB JOURNAL   27   2013年4月

  • The TaperGuard™ endotracheal tube intracuff pressure increase is less than that of the Hi-Lo™ tube during nitrous oxide exposure: a model trachea study. 査読 国際誌

    Sayaka Tsuboi, Tetsuya Miyashita, Yoshikazu Yamaguchi, Yoshiko Yamamoto, Kentaro Sakamaki, Takahisa Goto

    Anesthesia and analgesia   116 ( 3 )   609 - 12   2013年3月

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    BACKGROUND: Studies have compared sealing effects of the newly developed tapered endotracheal tube cuff with the conventional cylindrical cuff. In this study, we compared the difference between cuffs with regard to the increase in intracuff pressure during nitrous oxide (N(2)O) exposure. METHODS: Two types of cuffs were studied using a model trachea connected to a mechanical test lung: high-volume, low-pressure cuff (Mallinckrodt Hi-Lo(TM), Covidien, Dublin, Ireland) and tapered cuff (Mallinckrodt TaperGuardTM, Covidien). The intracuff pressure was set at 20 cm H(2)O, and the increase in pressure was measured during mechanical ventilation using 66% N(2)O. Intracuff pressures were recorded after 5, 10, 15, 30, 45, and 60 minutes of exposure to N(2)O. RESULTS: The intracuff pressure recorded during the first 15 minutes of N(2)O exposure in high-volume, low-pressure cuffs was significantly higher than tapered cuffs (2-way repeated-measures analysis of variance, P < 0.0001 for internal diameters [IDs] 7.0 and 7.5 mm, P = 0.0004 for ID 8.0 mm, P = 0.0013 for ID 8.5 mm), and there were also statistically significant differences regarding interaction of time and cuff type (P < 0.0001 for IDs 7.0, 7.5, 8.0, and 8.5 mm). The difference in mean cuff pressures among groups after 10 minutes of N(2)O exposure was -18.5 (SE, 1.4; 99% confidence interval, -22.8 to -14.2; P < 0.0001) for ID 7.5 mm. Tapered endotracheal tube cuffs sealed the trachea with fewer dimples on the carina side of the cuff. Dimples on the cuff surface probably increase the surface for N(2)O diffusion. Therefore, fewer dimples result in a smaller surface area through which N(2)O can diffuse. CONCLUSION: During general anesthesia with N(2)O, the intracuff pressure of tapered endotracheal tube cuffs did not increase as rapidly as it did in conventional high-volume, low-pressure cuffs. The pressure in both types of cuffs increased rapidly when exposed to 66% N(2)O, and hence continuous or frequent monitoring is recommended.

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  • Effects of volatile anesthetics on the circadian rhythms of rat hippocampal acetylcholine release and locomotor activity 査読

    Kikuchi T, Tan H, Mihara T, Uchimoto K, Mitsushima D, Takase K, Morita S, Goto T, Andoh T, Kamiya Y

    Neuroscience   237   151 - 160   2013年

  • Amount of accidental flush by syringe pump due to inappropriate release of occluded intravenous line. 査読

    Kawakami H, Miyashita T, Yanaizumi R, Mihara T, Sato H, Kariya T, Mizuno Y, Goto T

    Technology and health care : official journal of the European Society for Engineering and Medicine   21 ( 6 )   581 - 586   2013年

  • Alveolar Hypoxia During One-Lung Ventilation Leads To Hif-1 Activation And Lung Inflammation In The Non-Ventilated Lung

    K. Tojo, Y. Nagamine, S. Ota, Y. Baba, T. Goto, K. Kurahashi

    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE   187   2013年

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  • Bumetanide, an Inhibitor of Cation-chloride Cotransporter Isoform 1, Inhibits γ-Aminobutyric Acidergic Excitatory Actions and Enhances Sedative Actions of Midazolam in Neonatal Rats 査読 国際誌

    Yukihide Koyama, Tomio Andoh, Yoshinori Kamiya, Satoshi Morita, Tomoyuki Miyazaki, Kazuhiro Uchimoto, Takahiro Mihara, Takahisa Goto

    Anesthesiology   119 ( 5 )   1096 - 108   2013年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Ovid Technologies (Wolters Kluwer Health)  

    DOI: 10.1097/ALN.0b013e31829e4b05

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  • Day or night administration of ketamine and pentobarbital differentially affect circadian rhythms of pineal melatonin secretion and locomotor activity in rats. 査読 国際誌

    Mihara T, Kikuchi T, Kamiya Y, Koga M, Uchimoto K, Kurahashi K, Goto T

    Anesthesia and analgesia   115 ( 4 )   805 - 813   2012年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1213/ANE.0b013e3182632bcb

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  • Endoscopic Removal of Throat-Packing Gauze Swallowed During General Anesthesia 査読

    Toshinori Iwai, Takahisa Goto, Yoshiro Matsui, Iwai Tohnai

    JOURNAL OF CRANIOFACIAL SURGERY   23 ( 5 )   1547 - 1549   2012年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/SCS.0b013e3182564bb5

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  • Disrupted cortical function underlies behavior dysfunction due to social isolation 査読

    Tomoyuki Miyazaki, Kenkichi Takase, Waki Nakajima, Hirobumi Tada, Daisuke Ohya, Akane Sano, Takahisa Goto, Hajime Hirase, Roberto Malinow, Takuya Takahashi

    JOURNAL OF CLINICAL INVESTIGATION   122 ( 7 )   2690 - 2701   2012年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1172/JCI63060

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  • Cardiovascular intubation responses with Airway Scope and Macintosh laryngoscope reply

    Y. Koyama, M. Nishihama, G. Inagawa, Y. Kamiya, T. Miki, R. Kurihara, T. Goto

    ANAESTHESIA   67 ( 4 )   435 - 436   2012年4月

  • ICUにおける栄養管理 重症患者におけるビタミン濃度の検討

    速水 元, 水谷 健司, 塩田 将, 中易 夏子, 増渕 哲仁, 出井 真史, 後藤 隆久

    静脈経腸栄養   27 ( 1 )   251 - 251   2012年1月

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  • Developmental AMPA receptor subunit specificity during experience-driven synaptic plasticity in the rat barrel cortex 査読

    Tomoyuki Miyazaki, Misako Kunii, Hirobumi Tada, Akane Sano, Yoshiyuki Kuroiwa, Takahisa Goto, Roberto Malinow, Takuya Takahashi

    BRAIN RESEARCH   1435   1 - 7   2012年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.brainres.2011.11.033

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  • Comparison of haemodynamic responses to tracheal intubation using the Airway Scope® and Macintosh laryngoscope in normotensive and hypertensive patients 査読

    Koyama Y, Nishihama M, Inagawa G, Kamiya Y, Miki T, Kurihara R, Goto T

    Anaesthesia   66 ( 10 )   895 - 900   2011年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/j.1365-2044.2011.06802.x

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    その他リンク: http://orcid.org/0000-0001-9790-9867

  • Use of a hydrocolloid dressing to prevent nasal pressure sores after nasotracheal intubation 査読

    Toshinori Iwai, Takahisa Goto, Jiro Maegawa, Iwai Tohnai

    BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY   49 ( 7 )   E65 - E66   2011年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.bjoms.2011.01.016

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  • Keratinocyte growth factor gene transduction ameliorates pulmonary fibrosis induced by bleomycin in mice. 査読 国際誌

    Sakamoto S, Yazawa T, Baba Y, Sato H, Kanegae Y, Hirai T, Saito I, Goto T, Kurahashi K

    American journal of respiratory cell and molecular biology   45 ( 3 )   489 - 497   2011年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1165/rcmb.2010-0092OC

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  • Airway Scope Laryngoscopy Under Manual Inline Stabilization and Cervical Collar Immobilization: A Crossover In Vivo Cinefluoroscopic Study 査読

    Yoshihiro Aoi, Gaku Inagawa, Kozo Hashimoto, Hideo Tashima, Sayaka Tsuboi, Takeshi Takahata, Kyota Nakamura, Takahisa Goto

    JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE   71 ( 1 )   32 - 36   2011年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/TA.0b013e3181e75873

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  • Effects of erythropoietin on intracellular calcium concentration of rat primary cortical neurons 査読

    Tomio Andoh, Noriyuki Echigo, Yoshinori Kamiya, Michiko Hayashi, Ichidai Kudoh, Takahisa Goto

    Brain Research   1387   8 - 18   2011年4月

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    出版者・発行元:Elsevier {BV}  

    DOI: 10.1016/j.brainres.2011.02.077

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  • Evaluation of the Pentax-AWS <sup>®</sup> and the Macintosh laryngoscope in difficult intubation: A manikin study 査読

    T. Kariya, G. Inagawa, K. Nakamura, J. Fujimoto, Y. Aoi, S. Morita, T. Goto

    Acta Anaesthesiologica Scandinavica   55 ( 2 )   223 - 227   2011年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/j.1399-6576.2010.02363.x

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  • Intrathecally administered Sema3A protein attenuates neuropathic pain behavior in rats with chronic constriction injury of the sciatic nerve 査読

    Michiko Hayashi, Yoshinori Kamiya, Hideki Itoh, Tomoko Higashi, Tomoyuki Miyazaki, Kengo Funakoshi, Naoya Yamashita, Yoshio Goshima, Tomio Andoh, Yoshitsugu Yamada, Takahisa Goto

    Neuroscience Research   69 ( 1 )   17 - 24   2011年1月

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    記述言語:英語   出版者・発行元:Elsevier {BV}  

    DOI: 10.1016/j.neures.2010.09.006

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  • Airway scope versus macintosh laryngoscope in patients with simulated limitation of neck movements. 査読

    Aoi Y, Inagawa G, Nakamura K, Sato H, Kariya T, Goto T

    The Journal of trauma   69 ( 4 )   838 - 842   2010年10月

  • Tracheal intubation using Airway Scope(A (R)) in two patients with difficult airway during cardiopulmonary resuscitation 査読

    Mariko Baba, Junichi Fujimoto, Kenji Mizutani, Kyota Nakamura, Yoshitaka Kamiya, Masahide Ohtsuka, Takahisa Goto

    JOURNAL OF ANESTHESIA   24 ( 4 )   618 - 620   2010年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00540-010-0955-9

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  • A simple fibreoptic assisted laryngoscope for paediatric difficult intubation: a manikin study 査読

    K. Komiya, G. Inagawa, K. Nakamura, T. Kikuchi, J. Fujimoto, Y. Sugawara, T. Goto

    ANAESTHESIA   64 ( 4 )   425 - 429   2009年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/j.1365-2044.2008.05795.x

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  • Lidocaine Concentration in Cerebrospinal Fluid after Epidural Administration 査読

    Yoshinori Kamiya, Tatsuaki Kikuchi, Gaku Inagawa, Hiroshi Miyazaki, Masashi Miura, Satoshi Morita, Takahisa Goto

    Anesthesiology   110 ( 5 )   1127   2009年

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    出版者・発行元:Ovid Technologies (Wolters Kluwer Health)  

    DOI: 10.1097/ALN.0b013e31819daf15

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  • National survey of the association of depressive symptoms with the number of off-duties abd on -call,and sleeping hours among physicians working at hospitals in japan.

    GOTO Takahisa

    2009年

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  • Differential effects of isoflurane on A-type and delayed rectifier K channels in rat substantia nigra 査読

    Dai Ishiwa, Isao Nagata, Tatsuo Ohtsuka, Hideki Itoh, Yoshinori Kamiya, Kenichi Ogawa, Mariko Sakai, Nagaaki Sekino, Yoshitsugu Yamada, Takahisa Goto, Tomio Andoh

    EUROPEAN JOURNAL OF PHARMACOLOGY   580 ( 1-2 )   122 - 129   2008年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.ejphar.2007.10.062

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  • Randomized Prospective Study Comparing the Laryngeal Tube Suction II with the ProSeal™ Laryngeal Mask Airway in Anesthetized and Paralyzed Patients 査読

    Tatsuaki Kikuchi, Yoshinori Kamiya, Tsuyoshi Ohtsuka, Tomoko Miki, Takahisa Goto

    Anesthesiology   109 ( 1 )   54   2008年

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    出版者・発行元:Ovid Technologies (Wolters Kluwer Health)  

    DOI: 10.1097/ALN.0b013e318178819b

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  • Comparison of the Airway Scope®, gum elastic bougie and fibreoptic bronchoscope in simulated difficult tracheal intubation: A manikin study

    Y. Koyama, Gaku Inagawa, T. Miyashita, T. Kikuchi, N. Miura, T. Miki, R. Kurihara, Y. Kamiya, T. Goto

    Anaesthesia   62 ( 9 )   936 - 939   2007年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/j.1365-2044.2007.05152.x

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  • High tidal volume ventilation induces lung injury after hepatic ischemia-reperfusion 査読

    Shuhei Ota, Kyota Nakamura, Takuya Yazawa, Yosuke Kawaguchi, Yasuko Baba, Ritsuko Kitaoka, Naoto Morimura, Takahisa Goto, Yoshitsugu Yamada, Kiyoyasu Kurahashi

    AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY   292 ( 3 )   L625 - L631   2007年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1152/ajplung.00151.2006

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  • Keratinocyte growth factor gene transduction ameliorates acute lung injury and mortality in mice. 査読

    Baba Y, Yazawa T, Kanegae Y, Sakamoto S, Saito I, Morimura N, Goto T, Yamada Y, Kurahashi K

    Human gene therapy   18 ( 2 )   130 - 141   2007年2月

  • The effect of isoflurane on the oxygen radical level in primary cultures of rat cortical neurons 査読

    Echigo N, Saitou Sibakawa Y, Kamiya Y, Yamada Y, Goto T, Andoh T

    Yokohama Medical Journal   58 ( 1 )   17 - 23   2007年

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    記述言語:日本語   出版者・発行元:横浜市立大学医学会  

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  • A(1) adenosine receptor-mediated modulation of neuronal ATP-sensitive K channels in rat substantia nigra

    Tomio Andoh, Dai Ishiwa, Yoshinori Kamiya, Noriyuki Echigo, Takahisa Goto, Yoshitsugu Yamada

    BRAIN RESEARCH   1124 ( 1 )   55 - 61   2006年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.brainres.2006.09.085

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  • Hypertension and anesthesia. 査読

    Hanada S, Kawakami H, Goto T, Morita S

    Current opinion in anaesthesiology   19 ( 3 )   315 - 319   2006年6月

  • Nitrogen accumulation during closed circuit anesthesia depends on the type of surgery. 国際誌

    Pia Hanne, Takahisa Goto, Yoshinori Nakata, Yoshiki Ishiguro, Shigeho Morita

    Journal of clinical anesthesia   17 ( 7 )   504 - 8   2005年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    STUDY OBJECTIVE: The aim of this study is to test the hypothesis that the amount of nitrogen that accumulates within the closed breathing system would be greater during open abdominal surgery than during superficial surgery with small wounds. DESIGN: Prospective, comparative study. SETTING: Operating rooms of a university hospital. PATIENTS: Fourteen American Society of Anesthesiologists physical status I and II adult patients scheduled for abdominal surgery (n = 7) or tympanoplasty (n = 7). INTERVENTIONS: After induction of anesthesia and endotracheal intubation, the patients were denitrogenated for 30 minutes using 100% oxygen at a fresh gas flow of 10 L/min. The breathing system was then closed and patients were anesthetized using 60% xenon in oxygen, supplemented with epidural anesthesia in the abdominal surgery group and sevoflurane in the tympanoplasty group. MEASUREMENTS: Nitrogen concentration in the breathing system was determined by gas chromatography immediately before and 2 hours after the breathing system was closed. MAIN RESULTS: The median (range) increase in nitrogen concentration during the 2-hour period of closed circuit anesthesia was greater in the abdominal surgery patients than in the tympanoplasty patients (6.5% [4.0%-10.2%] vs 2.5% [1.4%-8.4%], P = 0.035, Mann-Whitney U test). CONCLUSIONS: The amount of nitrogen accumulation during closed circuit anesthesia is greater during open abdominal surgery than in superficial surgery such as tympanoplasty. We postulate that during open abdominal surgery, nitrogen in the ambient air enters the body across the peritoneum and then diffuses into the alveoli to be exhaled.

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  • The bispectral index predicts responsiveness to verbal commands in patients emerging from nitrous oxide anesthesia supplemented with a subhypnotic concentration of isoflurane

    GOTO TAKAHISA, ISHIGURO YOSHIKI, NAKATA YOSHINORI, MORITA SHIGEHO

    Journal of anesthesia   19 ( 2 )   102 - 105   2005年5月

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  • キセノン

    後藤 隆久

    医科器械学 = The Japanese journal of medical instrumentation   74 ( 3 )   105 - 110   2004年3月

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    記述言語:日本語   出版者・発行元:日本医療機器学会  

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  • Does xenon anesthesia inhibit cholinesterases? An in vitro radiometric assessment

    Y Ishiguro, T Kikuchi, H Etsuki, Y Niimi, T Goto, S Morita, T Irie

    ANESTHESIOLOGY   98 ( 3 )   791 - 792   2003年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/00000542-200303000-00034

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  • Will xenon be a stranger or a friend? The cost, benefit, and future of xenon anesthesia

    T Goto, Y Nakata, S Morita

    ANESTHESIOLOGY   98 ( 1 )   1 - 2   2003年1月

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  • The minimum alveolar concentration of xenon in the elderly is sex-dependent

    T Goto, Y Nakata, S Morita

    ANESTHESIOLOGY   97 ( 5 )   1129 - 1132   2002年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Pollution of the medical air at a university hospital in the metropolitan Tokyo area. 国際誌

    Yoshinori Nakata, Yukari Kawasaki, Koichi Matsukawa, Takahisa Goto, Yoshinari Niimi, Shigeho Morita

    Journal of clinical anesthesia   14 ( 3 )   193 - 5   2002年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    STUDY OBJECTIVE: To investigate the quality of medical air in a hospital in the metropolitan area. DESIGN: Prospective study. SETTING: University hospital in the metropolitan Tokyo area. INTERVENTIONS: Medical air introduced into a bio-clean operating room was sampled. MEASUREMENTS: The concentrations of nitric monoxide (NO), nitrogen dioxide (NO(2)), sulfur dioxide (SO(2)), and carbon monoxide (CO) in the medical air were measured every 30 minutes for 15 days. MAIN RESULTS: The concentrations (mean +/- SD) of NO, NO(2), SO(2), and CO were 34.4 +/- 35.0 ppb (range 0-200 ppb), 7.7 +/- 5.5 ppb (0-29 ppb), 33.8 +/- 2.9 ppb (21-46 ppb), and 1.65 +/- 0.87 ppm (0.5-7.5 ppm), respectively. The concentrations of these gases peaked at rush hours within a day. CONCLUSIONS: In the metropolitan area, we occasionally provide our patients with medical air of poor quality.

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  • Is there a future for xenon anesthesia?

    T Goto

    CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE   49 ( 4 )   335 - 338   2002年4月

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    記述言語:英語  

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  • The midlatency auditory evoked potentials predict responsiveness to verbal commands in patients emerging from anesthesia with xenon, isoflurane, and sevoflurane but not with nitrous oxide

    T Goto, Y Nakata, H Saito, Y Ishiguro, Y Niimi, S Morita

    ANESTHESIOLOGY   94 ( 5 )   782 - 789   2001年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Minimum alveolar concentration (MAC) of xenon with sevoflurane in humans

    Y Nakata, T Goto, Y Ishiguro, K Terui, H Kawakami, M Santo, Y Niimi, S Morita

    ANESTHESIOLOGY   94 ( 4 )   611 - 614   2001年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • キセノン麻酔に未来はあるか?

    後藤 隆久

    臨床麻酔   26/9, 1429-37   2001年

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  • Prediction of difficult airway in school-aged patients with microtia

    Shoichi Uezono, Robert S. Holzman, Takahisa Goto, Yoshinori Nakata, Satoru Nagata, Shigeho Morita

    Paediatric Anaesthesia   11 ( 4 )   409 - 413   2001年

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1046/j.1460-9592.2001.00683.x

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  • Platelet adhesion to heparin coated oxygenator fibers under in vitro static conditions: Impact of temperature

    Yoshinari Niimi, Yoshiki Ishiguro, Yoshinori Nakata, Takahisa Goto, Shigeho Morita, Shingo Yamane

    ASAIO Journal   47 ( 4 )   361 - 364   2001年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Lippincott Williams and Wilkins  

    DOI: 10.1097/00002480-200107000-00013

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  • 脳波のスペクトル解析と麻酔深皮―BISからの洞察

    後藤 隆久

    麻酔   50/, 131-6   2001年

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  • Minimum alveolar concentration-awake of xenon alone and in combination with isoflurane or sevoflurane

    T Goto, Y Nakata, Y Ishiguro, Y Niimi, K Suwa, S Morita

    ANESTHESIOLOGY   93 ( 5 )   1188 - 1193   2000年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Bispectral analysis of the electroencephalogram does not predict responsiveness to verbal command in patients emerging from xenon anaesthesia

    T Goto, Y Nakata, H Saito, Y Ishiguro, Y Niimi, K Suwa, S Morita

    BRITISH JOURNAL OF ANAESTHESIA   85 ( 3 )   359 - 363   2000年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Effect of xenon on autonomic cardiovascular control - Comparison with isoflurane and nitrous oxide 査読

    Y Ishiguro, T Goto, Y Nakata, K Terui, Y Niimi, S Morita

    JOURNAL OF CLINICAL ANESTHESIA   12 ( 3 )   196 - 201   2000年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Plasma concentration of fentanyl with xenon to block somatic and hemodynamic responses to surgical incision

    Y Nakata, T Goto, H Saito, Y Ishiguro, K Terui, H Kawakami, Y Tsuruta, Y Niimi, S Morita

    ANESTHESIOLOGY   92 ( 4 )   1043 - 1048   2000年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Risk attitudes of anesthesiologists and surgeons in clinical decision making with expected years of life 査読

    Y Nakata, M Okuno-Fujiwara, T Goto, S Morita

    JOURNAL OF CLINICAL ANESTHESIA   12 ( 2 )   146 - 150   2000年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Emergence agitation after sevoflurane versus propofol in pediatric patients

    Shoichi Uezono, Takahisa Goto, Katsuo Terui, Fumito Ichinose, Yoshiki Ishguro, Yoshinori Nakata, Shigeho Morita

    Anesthesia and Analgesia   91 ( 3 )   563 - 566   2000年

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1213/00000539-200009000-00012

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  • Thermoregulatory thresholds for vasoconstriction in patients anesthetized with various 1-minimum alveolar concentration combinations of xenon, nitrous oxide, and isoflurane

    T Goto, T Matsukawa, DI Sessler, S Uezono, Y Ishiguro, M Ozaki, S Morita

    ANESTHESIOLOGY   91 ( 3 )   626 - 632   1999年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/00000542-199909000-00011

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  • Cost analysis of xenon anesthesia: A comparison with nitrous oxide-isoflurane and nitrous oxide-sevoflurane anesthesia 査読

    Y Nakata, T Goto, Y Niimi, S Morita

    JOURNAL OF CLINICAL ANESTHESIA   11 ( 6 )   477 - 481   1999年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Hemodynamic responses to incision fail to predict the changes in plasma norepinephrine during sevoflurane-xenon anesthesia

    Y Nakata, T Goto, Y Ishiguro, S Morita

    ANESTHESIOLOGY   91 ( 3A )   U223 - U223   1999年9月

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  • Xenon suppresses the increases in bispectral index in response to stimulation

    Y Nakata, T Goto, Y Niimi, S Morita

    ANESTHESIOLOGY   91 ( 3A )   U224 - U224   1999年9月

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  • Anesthetic doses of sevoflurane to block cardiovascular responses to incision when administered with xenon or nitrous oxide

    Y Nakata, T Goto, Y Ishiguro, K Terui, Y Niimi, S Morita

    ANESTHESIOLOGY   91 ( 2 )   369 - 373   1999年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/00000542-199908000-00009

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  • Insertion of the cuffed oropharyngeal airway (COPA) with propofol or sevoflurane in adults

    Takahisa Goto, Yoshinori Nakata, Shoichi Uezono, Yoshinari Niimi, Masanori Uchiyama, Shigeho Morita

    Journal of Clinical Anesthesia   11 ( 4 )   280 - 284   1999年6月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/S0952-8180(99)00037-9

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  • Preoperative pulse wave velocity fails to predict hemodynamic responses to anesthesia and to surgical stimulation 査読

    Y Nakata, T Goto, Y Ishiguro, K Terui, Y Niimi, S Morita

    JOURNAL OF CLINICAL ANESTHESIA   11 ( 4 )   285 - 289   1999年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Electroencephalographic responses to the formalin test in rats

    F Ichinose, M Miyazaki, T Goto, H Takahashi, K Terui, Y Niimi, S Uezono, S Morita, H Yanagida

    PAIN   80 ( 1-2 )   251 - 256   1999年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/S0304-3959(98)00213-9

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  • Platelet hyporeactivity in young infants during cardiopulmonary bypass

    Fumito Ichinose, Shoichi Uezono, Rika Muto, Haruo Uchida, Fumimaro Hatori, Katsuo Terui, Yoshinari Niimi, Takahisa Goto, Yoshinori Nakata, Shigeho Morita

    Anesthesia and Analgesia   88 ( 2 )   258 - 262   1999年2月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/00000539-199902000-00006

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  • Effects of xenon on the performance of various respiratory flowmeters

    T Goto, H Saito, Y Nakata, S Uezono, F Ichinose, M Uchiyama, S Morita

    ANESTHESIOLOGY   90 ( 2 )   555 - 563   1999年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/00000542-199902000-00032

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  • Effects of xenon on hemodynamic responses to skin Incision in humans

    Y Nakata, T Goto, S Morita

    ANESTHESIOLOGY   90 ( 2 )   406 - 410   1999年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/00000542-199902000-00013

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  • The placement of the cuffed oropharyngeal airway with sevoflurane in adults: A comparison with the laryngeal mask airway

    Yoshinori Nakata, Takahisa Goto, Hayato Saito, Fumito Ichinose, Shoichi Uezono, Shigeho Morita

    Anesthesia and Analgesia   87 ( 1 )   143 - 146   1998年7月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/00000539-199807000-00030

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  • Comparison of acceleromyography and electromyography in vecuronium- induced neuromuscular blockade with xenon or sevoflurane anesthesia

    Yoshinori Nakata, Takahisa Goto, Hayato Saito, Fumito Ichinose, Shoichi Uezono, Kunio Suwa, Shigeho Morita

    Journal of Clinical Anesthesia   10 ( 3 )   200 - 203   1998年5月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/S0952-8180(98)00006-3

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  • Relationship between end-tidal and arterial carbon dioxide partial pressure using a cuffed oropharyngeal airway and a tracheal tube

    Y. Nakata, T. Goto, S. Uezono, F. Sasaki, S. Morita

    British Journal of Anaesthesia   80 ( 2 )   253 - 254   1998年2月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1093/bja/80.2.253

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  • The blood-gas partition coefficient of xenon may be lower than generally accepted

    T Goto, K Suwa, S Uezono, F Ichinose, M Uchiyama, S Morita

    BRITISH JOURNAL OF ANAESTHESIA   80 ( 2 )   255 - 256   1998年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Vecuronium-induced neuromuscular block during xenon or sevoflurane anaesthesia in humans

    Y Nakata, T Goto, S Morita

    BRITISH JOURNAL OF ANAESTHESIA   80 ( 2 )   238 - 240   1998年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • The cuffed oropharyngeal airway, a novel adjunct to the management of difficult airways

    Shoichi Uezono, Takahisa Goto, Yoshinori Nakata, Fumito Ichinose, Yosinari Niimi, Shigeho Morita

    Anesthesiology   88 ( 6 )   1677 - 1679   1998年

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/00000542-199806000-00036

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  • Emergence times from xenon anaesthesia are independent of the duration of anaesthesia

    T Goto, H Saito, Y Nakata, S Uezono, F Ichinose, S Morita

    BRITISH JOURNAL OF ANAESTHESIA   79 ( 5 )   595 - 599   1997年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Comparison of inhalation inductions with xenon and sevoflurane

    Y Nakata, T Goto, S Morita

    ACTA ANAESTHESIOLOGICA SCANDINAVICA   41 ( 9 )   1157 - 1161   1997年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Xenon provides faster emergence from anesthesia than does nitrous oxide sevoflurane or nitrous oxide isoflurane

    T Goto, H Saito, M Shinkai, Y Nakata, F Ichinose, S Morita

    ANESTHESIOLOGY   86 ( 6 )   1273 - 1278   1997年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1097/00000542-199706000-00007

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  • Priming of anesthesia circuit with xenon for closed circuit anesthesia

    H Saito, M Saito, T Goto, S Morita

    ARTIFICIAL ORGANS   21 ( 1 )   70 - 72   1997年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • 亜酸化窒素は必要か(共著)

    後藤 隆久

    臨床麻酔   21/,420-426   420 - 426   1997年

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  • Volatile anaesthetics antagonize nitrous oxide and morphine-induced analgesia in the rat

    T Goto, JJA Marota, G Crosby

    BRITISH JOURNAL OF ANAESTHESIA   76 ( 5 )   702 - 706   1996年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • 注入型気化器を用いた閉鎖循環式麻酔の試み

    齊藤 勇人, 後藤 隆久, 新見 能成, 福家 伸夫, 森田 茂穂

    日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia   15 ( 10 )   685 - 689   1995年12月

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    記述言語:日本語  

    DOI: 10.2199/jjsca.15.685

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▼全件表示

書籍等出版物

  • データで変える病院経営

    後藤 隆久, 原 広司, 田中 利樹, 黒木 淳, 今中 雄一

    中央経済社  2022年3月  ( ISBN:4502419214

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    総ページ数:286   記述言語:日本語  

    CiNii Books

    ASIN

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  • 医師のストレス

    中外医学者  2009年 

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MISC

  • 尿路感染による敗血症性ショックに,心筋虚血による二次性の心原性ショックを合併し,管理に難渋した症例

    酒井洋平, 長嶺祐介, 出井真史, 横山暢幸, 横瀬真志, 柏木静, 高木俊介, 後藤隆久

    日本集中治療医学会学術集会(Web)   50th   2023年

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  • 中心静脈カテーテル挿入時に右内頸静脈内にフラップ様構造物を認めた1症例

    渡邊 南穂, 川名 由貴, 長嶺 祐介, 水野 祐介, 後藤 隆久

    麻酔   71 ( 12 )   1318 - 1321   2022年12月

  • vascular slingに合併した先天性気管狭窄症に対する人工呼吸管理の1症例

    濱田 貴子, 菅原 陽, 長嶺 祐介, 桑原 香折, 安西 晃子, 横山 暢幸, 柏木 静, 高木 俊介, 後藤 隆久

    麻酔   71 ( 7 )   776 - 779   2022年7月

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    記述言語:日本語   出版者・発行元:克誠堂出版(株)  

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  • 結腸膀胱瘻に起因した高クロール性代謝性アシドーシスの一例

    田中 宏幸, 長嶺 祐介, 吉田 輔, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   29 ( 3 )   229 - 230   2022年5月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • Asymptomatic Penetration of the Median Nerve by a Peripherally Inserted Central Catheter: A Case Report. 国際誌

    Masaru Kikuchi, Mana Sawada, Takeshi Nomura, Yusuke Mizuno, Takahisa Goto

    A&A practice   16 ( 3 )   e01577   2022年3月

     詳細を見る

    記述言語:英語  

    We report a rare case in which a peripherally inserted central catheter (PICC) asymptomatically penetrated the median nerve. The patient was a 71-year-old man who displayed no neurological symptoms until 4 days after PICC placement. An ultrasound scan revealed that the PICC had penetrated the median nerve. He underwent surgery to remove the catheter and had no sequelae. When placing a PICC, selecting the brachial vein as a puncture site is associated with a high risk of nerve injury. Furthermore, circumspect observation is needed until withdrawal as neurological symptoms may be absent even when the catheter has punctured a nerve.

    DOI: 10.1213/XAA.0000000000001577

    PubMed

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  • 気管チューブのポリウレタン製カフには8時間で水滴が貯留する:in vitroシミュレーション研究

    井上真光人, 中澤亮介, 出井真史, 高木俊介, 入江友哉, 後藤隆久

    日本麻酔科学会学術集会(Web)   69th   2022年

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  • 声門狭窄を合併した再発性多発軟骨炎患者の周術期気道管理の経験

    菊西 陽香, 井上 真光人, 山本 匠, 東條 健太郎, 吉田 輔, 横山 暢幸, 横瀬 真志, 入江 友哉, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   28 ( Suppl.2 )   362 - 362   2021年9月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 化学療法(mFOLFOX療法)施行中に認めた5-fluorouracil(FU)による乳酸アシドーシス、著明な高アンモニア血症に対して血液透析を施行した一例

    今井 祥子, 菅原 陽, 田中 宏幸, 横山 暢幸, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   28 ( 4 )   289 - 290   2021年7月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 症例報告 肺高血圧を合併した衝心脚気

    田中 宏幸, 菅原 陽, 今井 祥子, 吉田 輔, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   28 ( 4 )   294 - 295   2021年7月

     詳細を見る

    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 症例報告 肺高血圧を合併した衝心脚気

    田中 宏幸, 菅原 陽, 今井 祥子, 吉田 輔, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   28 ( 4 )   294 - 295   2021年7月

  • 低酸素誘発性肺高血圧クライシス動物モデルにおけるドブタミン単剤投与の有効性の検討

    奥真哉, 澤田侑理, 水野祐介, 菅原陽, 後藤隆久

    日本麻酔科学会学術集会(Web)   68th   2021年

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  • モノクロタリン誘発肺高血圧症ラットの肺動脈におけるprotein kinase Dの役割の解明

    奥真哉, 長嶺祐介, 菅原陽, 水野祐介, 後藤隆久

    Cardiovascular Anesthesia   25 ( Suppl (CD-ROM) )   2021年

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  • 麻酔科医の業務効率化,業務委託のための全麻酔科医タイムスタディ

    水野祐介, 山内朋子, 後藤隆久

    日本麻酔科学会学術集会(Web)   68th   2021年

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  • 喉頭エコーのピットフォール 披裂部エコーの動きにより正常と誤認したfloppy arytenoidの1症例

    奥 真哉, 小林 綾子, 山口 嘉一, 水野 祐介, 野村 岳志, 後藤 隆久

    麻酔   69 ( 2 )   143 - 146   2020年2月

  • 低酸素誘発性肺高血圧クライシス動物モデルにおけるドブタミン単剤投与の有効性の検討

    武田悠, 奥真哉, 古賀資和, 菅原陽, 水野祐介, 後藤隆久

    日本麻酔科学会学術集会(Web)   67th   2020年

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  • 気管内浸潤を伴った甲状腺腫瘍が緊急気道確保時に脱落し、その摘出が困難であった一例

    高田 一哉, 出井 真史, 高橋 紗緒梨, 大塚 将秀, 後藤 隆久

    日本集中治療医学会雑誌   26 ( 3 )   201 - 202   2019年5月

  • 妊娠による循環血漿量増加で顕在化した肺水腫に対し、多職種による集学的治療が功を奏した左房腫瘍の一例

    桑原 香折, 菅原 陽, 安西 晃子, 辻 匠子, 横山 暢幸, 濱田 貴子, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   26 ( Suppl. )   [P33 - 2]   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 集中治療室入室患者に対する天井設置型マイクロ波ドップラーセンサによる呼吸回数測定の正確性の検討

    田中 宏幸, 横瀬 真志, 安西 晃子, 桑原 香折, 辻 匠子, 濱田 貴子, 柏木 静, 菅原 陽, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   26 ( Suppl. )   [O63 - 1]   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 血球貪食症候群および真菌感染による低酸素血症に対しECMOを用いた集学的治療により救命しえた小児の一例

    辻 匠子, 菅原 陽, 高木 俊介, 桑原 香折, 安西 晃子, 濱田 貴子, 横山 暢幸, 柏木 静, 横瀬 真志, 後藤 隆久

    日本集中治療医学会雑誌   26 ( Suppl. )   [P69 - 3]   2019年2月

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  • Vascular slingに先天性気管狭窄症を合併し呼吸管理に難渋した一例

    濱田 貴子, 菅原 陽, 桑原 香折, 安西 晃子, 横山 暢幸, 辻 匠子, 柏木 静, 横瀬 真志, 高木 俊介, 後藤 隆久

    日本集中治療医学会雑誌   26 ( Suppl. )   [P4 - 2]   2019年2月

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  • 横浜市立大学附属病院における周麻酔期看護師の業務の実態および周術期管理への貢献

    井出悠紀子, 大山亜希子, 田中菜奈子, 長嶺祐介, 藤本寛子, 宮下徹也, 水野祐介, 後藤隆久

    日本手術医学会誌   40   2019年

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  • 気管内浸潤を伴った甲状腺腫瘍が緊急気道確保時に脱落し,その摘出が困難であった一例

    高田一哉, 出井真史, 高橋紗緒梨, 大塚将秀, 後藤隆久

    日本集中治療医学会雑誌(Web)   26 ( 3 )   2019年

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  • 後腹膜原発の巨大パラガングリオーマ(副腎外褐色細胞腫)摘出術の麻酔管理の1症例 査読

    白田 祥子, 近藤 有理子, 入澤 朋子, 長嶺 祐介, 水野 祐介, 後藤 隆久

    麻酔   67 ( 12 )   1309 - 1312   2018年12月

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  • 十分な覚醒が得られず、覚醒下開頭腫瘍摘出術を断念した1症例

    松田 優子, 西周 祐美, 水野 祐介, 後藤 隆久

    麻酔   67 ( 7 )   748 - 751   2018年7月

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  • pectoral nerve blockのみで乳房部分切除手術を管理しえた1症例

    山本 夏啓, 水野 祐介, 野村 岳志, 後藤 隆久

    麻酔   67 ( 6 )   611 - 613   2018年6月

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  • Anesthetic management of a Rett syndrome patient with apnea and epilepsy: a case report. 国際誌

    Yuka Motomura, Masafumi Idei, Hitoshi Sato, Takahisa Goto

    JA clinical reports   4 ( 1 )   32 - 32   2018年4月

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    Rett syndrome, which is a progressive, central nervous system disease that is caused by a gene mutation, is known to present with various symptoms. This case is that of a 15-year-old girl who was diagnosed with Rett syndrome at the age of 2 years. Laryngotracheal isolation under general anesthesia was planned due to recurrent aspiration pneumonia. Since the patient's nutritional status and control of convulsions were good, this was deemed an appropriate time for the surgery. Following careful preoperative evaluation of her airway, we performed oral endotracheal intubation using a video laryngoscope after rapid induction. Since postoperative pain control was important to prevent apneic attacks and convulsions, we used a multimodal analgesic regimen including carefully titrated fentanyl, acetaminophen, nonsteroidal anti-inflammatory drug, and wound infiltration with a local anesthetic. Postoperatively, the patient returned to the intensive care unit under spontaneous ventilation and followed a good course. Patients with Rett syndrome present several symptoms. Thus, several points must be considered during the preoperative evaluation, anesthetic management, and postoperative care of these patients.

    DOI: 10.1186/s40981-018-0169-y

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  • Intraoperative Venovenous Extracorporeal Membrane Oxygenation During Thoracic Surgery That Requires 1-Lung Ventilation: A Case Report. 査読

    Miyamoto Y, Nagamine Y, Goto T, Kurahashi K

    A&A practice   10 ( 4 )   79 - 82   2018年2月

  • PI値はClearSightによる心拍出量測定の正確性の指標となるか?

    横瀬 真志, 早川 翔, 田中 宏幸, 濱田 貴子, 吉田 輔, 高木 俊介, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   25 ( Suppl. )   [O72 - 5]   2018年2月

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  • 気管内浸潤を伴った甲状腺腫瘍が緊急気道確保時に脱落し、その摘出が困難であった一例

    高田 一哉, 出井 真史, 佐野 友里香, 高橋 紗緒梨, 大塚 将秀, 後藤 隆久

    日本集中治療医学会雑誌   25 ( Suppl. )   [P66 - 1]   2018年2月

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  • In Response. 査読 国際誌

    Maai Hino, Takahiro Mihara, Koui Ka, Takahisa Goto

    Anesthesia and analgesia   126 ( 1 )   365 - 366   2018年1月

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  • 筋委縮性側索硬化症合併患者に対する喉頭気管分離術3症例における全身麻酔管理

    奥山志織, 入江友哉, 水野祐介, 後藤隆久

    日本麻酔科学会学術集会(Web)   65th   2018年

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  • Fontan手術翌日に著明な肝酵素上昇を来した一例

    田中 宏幸, 横瀬 真志, 吉田 輔, 長嶺 祐介, 入江 友哉, 岡村 健太, 後藤 隆久

    Cardiovascular Anesthesia   22 ( Suppl. )   284 - 284   2017年9月

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    記述言語:日本語   出版者・発行元:(一社)日本心臓血管麻酔学会  

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  • 横浜市立大学における周麻酔期看護師の役割と養成 (第38回総会特集(2))

    井出 悠紀子, 小川 知子, 後藤 隆久, 馬場 靖子

    日本手術医学会誌   38 ( 2 )   152 - 154   2017年5月

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    記述言語:日本語   出版者・発行元:日本手術医学会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2017385261

  • 食道ESDに対するプロポフォール・デクスメデトミジン塩酸塩併用鎮静の実現性

    野中 敬, 稲森 正彦, 宮下 徹也, 原田 紳介, 稲生 優海, 鹿野島 健二, 松浦 瑞恵, 日暮 琢磨, 大久保 秀則, 飯田 洋, 遠藤 宏樹, 日下部 明彦, 前田 慎, 後藤 隆久, 中島 淳

    Gastroenterological Endoscopy   59 ( 2 )   226 - 233   2017年2月

  • L-DOPAの肺高血圧モデル肺血管におけるフェニレフリン応答の修飾作用

    古賀資和, 古賀資和, 増川太輝, 中村史雄, 中村史雄, 菅原陽, 水野祐介, 後藤隆久, 五嶋良郎

    日本薬理学雑誌   150 ( Supplement )   2017年

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  • 抜管基準とされるPressure Supportで換気されている新生児の抜管前後の呼吸仕事量の変化

    佐々木誠, 山口嘉一, 松田優子, 宮下徹也, 大塚将秀, 山口修, 後藤隆久

    日本集中治療医学会学術集会(Web)   44th   ROMBUNNO.DP148‐5 (WEB ONLY)   2017年

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    記述言語:日本語  

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  • 肺動脈狭窄に伴う右心不全を合併したJatene手術既往患者に対する帝王切開を脊髄くも膜下硬膜外併用麻酔で良好に管理しえた1症例 査読

    月永晶人, 入江友哉, 内本一宏, 宮下徹也, 後藤隆久

    麻酔   65 ( 10 )   1031‐1033 - 1033   2016年10月

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    記述言語:日本語   出版者・発行元:克誠堂出版  

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  • 成長発達遅延と先天性気管狭窄症を合併した小児の一例

    桑原 沙代子, 宮崎 敦, 倉橋 清泰, 後藤 隆久

    日本臨床麻酔学会誌   36 ( 6 )   S261 - S261   2016年10月

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    記述言語:日本語   出版者・発行元:日本臨床麻酔学会  

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  • 心臓術後の重度左心低機能患者に対する鎖骨下動脈送血によるECMO

    春原 啓人, 寺端 昭博, 岡村 健太, 入江 友哉, 水野 祐介, 後藤 隆久

    日本臨床麻酔学会誌   36 ( 6 )   S288 - S288   2016年10月

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  • レボブピバカイン3mg/kgを使用した術後腹直筋鞘ブロックで局所麻酔薬中毒を来した1例

    渕田 瑛, 菅原 泰常, 大川 卓巳, 倉橋 清泰, 後藤 隆久

    日本臨床麻酔学会誌   36 ( 6 )   S300 - S300   2016年10月

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    記述言語:日本語   出版者・発行元:日本臨床麻酔学会  

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  • ERCP中にガス塞栓によりCPAをきたした1症例

    片倉 友美, 山口 嘉一, 出井 真史, 吉田 輔, 高木 俊介, 野村 岳志, 山口 修, 後藤 隆久

    日本臨床麻酔学会誌   36 ( 6 )   S381 - S381   2016年10月

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    記述言語:日本語   出版者・発行元:日本臨床麻酔学会  

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  • 巨大褐色細胞腫摘出後の重篤な循環不全に対し、バソプレシンとホスホジエステラーゼIII阻害薬を投与した症例 査読

    長嶺 祐介, 西成田 玲子, 水谷 健司, 後藤 隆久

    麻酔   65 ( 6 )   624 - 627   2016年6月

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    記述言語:日本語   出版者・発行元:克誠堂出版(株)  

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    その他リンク: http://search.jamas.or.jp/link/ui/2016318635

  • 術後の硬膜外鎮痛中に両下肢ミオクローヌス様不随意運動を生じた1症例

    土岐 圭伊子, 横瀬 真志, 宮下 徹也, 佐藤 仁, 藤本 寛子, 山本 沙代子, 後藤 隆久

    麻酔   65 ( 6 )   628 - 631   2016年6月

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    記述言語:日本語   出版者・発行元:克誠堂出版(株)  

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  • Evaluation of the maximum force onto the maxillary incisors during endotracheal intubation using simulator. Comparison by anesthetic experience or by types of laryngoscope. 査読

    Okamoto R, Sato H, Irie T, Miyashita T, Nomura T, Goto T

    Euroanesthesia 2016   2016年5月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)  

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  • 肝不全に対するOn-line HDF施行中にバンコマイシン持続投与を行った症例

    堺 結有, 高木 俊介, 金城 梢, 山本 夏啓, 西周 祐美, 出井 真史, 吉田 輔, 山口 嘉一, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   23 ( Suppl. )   539 - 539   2016年1月

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  • HELLP症候群に対する帝王切開術後に右肝梗塞を呈した1例

    西周 祐美, 山口 嘉一, 山本 夏啓, 堺 結有, 出井 真史, 吉田 輔, 高木 俊介, 野村 岳志, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   23 ( Suppl. )   464 - 464   2016年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 頸部超音波検査により抜管前に食道癌術後の両側反回神経麻痺を診断し得た1例

    山本 夏啓, 山口 嘉一, 堺 結有, 西周 祐美, 吉田 輔, 出井 真史, 高木 俊介, 野村 岳志, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   23 ( Suppl. )   550 - 550   2016年1月

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  • 食道癌術後に冠動脈攣縮による心停止をきたした1症例

    出井 真史, 水谷 健司, 小坂 隆司, 山本 夏啓, 堺 結有, 吉田 輔, 山口 嘉一, 高木 俊介, 山口 修, 後藤 隆久

    日本集中治療医学会雑誌   23 ( Suppl. )   554 - 554   2016年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 炎症反応が亢進した周術期において,高張アルブミンと晶質液が全拡張周期容量や肺血管外水分量に与える影響について

    高木俊介, 山本夏啓, 堺結有, 西周祐美, 吉田輔, 出井真史, 山口嘉一, 野村岳志, 山口修, 後藤隆久

    日本呼吸療法医学会学術集会プログラム・抄録集   38th   2016年

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  • 皮膚筋炎に伴う間質性肺炎に縦隔気腫を合併し,ECMOを要した一例

    松田優子, 山本夏啓, 出井真史, 吉田輔, 山口嘉一, 高木俊介, 山口修, 後藤隆久

    日本呼吸療法医学会学術集会プログラム・抄録集   38th   2016年

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  • 小児心臓外科術後におけるHigh‐flow nasal cannula(HFNC)の有用性

    出井真史, 宮下徹也, 山本夏啓, 堺結有, 吉田輔, 松田優子, 山口嘉一, 高木俊介, 野村岳志, 山口修, 後藤隆久

    日本呼吸療法医学会学術総会プログラム・抄録集   38th   272   2016年

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  • 肝内胆管癌に対するEx Vivo Surgeryの麻酔管理

    河上唯史, 川上裕理, 佐藤仁, 後藤隆久

    臨床麻酔(真興交易)   39 ( 11 )   1559 - 1560   2015年11月

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  • 硬膜外麻酔で安全に管理しえた筋萎縮性側索硬化症患者の麻酔経験 査読

    新井悠介, 吉田輔, 水野祐介, 宮下徹也, 後藤隆久

    麻酔   64 ( 10 )   1062 - 1064   2015年10月

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  • Hypotension during spinal anaesthesia for caesarean section - a reply. 査読

    Yokose M, Mihara T, Goto T

    Anaesthesia   70 ( 10 )   1210   2015年10月

  • 単心室循環姑息術後の成人患者の開腹後腹膜腫瘍摘出術において未診断の副腎外褐色細胞腫が判明した1症例 査読

    幸野 真樹, 長嶺 祐介, 後藤 隆久

    麻酔   64 ( 9 )   985 - 988   2015年9月

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    記述言語:日本語   出版者・発行元:克誠堂出版(株)  

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    その他リンク: http://search.jamas.or.jp/link/ui/2016031653

  • 腫瘍随伴性天疱瘡患者における開腹腫瘍生検術の麻酔経験

    吉田 輔, 山口 嘉一, 後藤 隆久

    臨床麻酔   39 ( 6 )   923 - 924   2015年6月

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    記述言語:日本語   出版者・発行元:真興交易(株)医書出版部  

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  • The predictive ability of non-invasive haemodynamic parameters for hypotension during caesarean section: a prospective observational study

    M. Yokose, T. Mihara, Y. Sugawara, T. Goto

    ANAESTHESIA   70 ( 5 )   555 - 562   2015年5月

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  • 食道癌術後に冠動脈攣縮による心停止をきたした1症例

    出井 真史, 水谷 健司, 小坂 隆司, 吉田 輔, 松田 優子, 高木 俊介, 山口 修, 後藤 隆久

    ICUとCCU   39 ( 3 )   187 - 191   2015年3月

  • Effects of breathing pattern on oxygen delivery via a nasal or pharyngeal cannula

    Natsuhiro Yamamoto, Tetsuya Miyashita, Shunsuke Takaki, Takahisa Goto

    Respiratory Care   60   1804 - 1809   2015年1月

  • Self-inflicted oral penetration injury: An intravenous drip pole advanced from the mouth to the retroperitoneum

    Shunsuke Takaki, Osamu Yamaguchi, Naoto Morimura, Takahisa Goto

    International Journal of Surgery Case Reports   16   112 - 1125   2015年1月

  • 気道音モニタリングが有用であったESD中に喉頭痙攣を合併した一例

    野中 敬, 原田 紳介, 宮下 徹也, 稲生 優海, 鹿野島 健二, 松浦 瑞恵, 日暮 琢磨, 大久保 秀則, 飯田 洋, 遠藤 宏樹, 稲森 正彦, 後藤 隆久, 中島 淳

    神奈川医学会雑誌   42 ( 1 )   115 - 115   2015年1月

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  • Impalement oral injury: Ultrasonic scalpel is the best tool to cut off a toothbrush. 査読

    Yamaguchi Y, Miyashita T, Toki K, Takaki S, Goto T

    Technology and health care : official journal of the European Society for Engineering and Medicine   23 ( 5 )   685 - 690   2015年

  • 麻酔器・人工呼吸器によるVCV・DCVの新生児呼吸器モデルへの適用―シミュレーション研究―

    山口嘉一, 宮下徹也, 佐々木誠, 松田優子, 高木俊介, 塩田将, 水谷健司, 山口修, 後藤隆久

    日本集中治療医学会学術集会(Web)   42nd   DP109-3 (WEB ONLY)   2015年

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  • 手術室での安全対策 7 手術室の災害対策

    佐藤仁, 川上裕理, 横瀬真志, 宮下徹也, 菊地龍明, 後藤隆久

    臨床麻酔(真興交易)   38 ( 9 )   1314 - 1322   2014年9月

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  • MELATONIN RECEPTOR AGONIST FOR THE PREVENTION OF POSTOPERATIVE DELIRIUM IN ELDERLY PATIENTS: A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL

    Y. Yamaguchi, T. Mihara, M. Taguri, O. Yamaguchi, T. Goto

    INTENSIVE CARE MEDICINE   40   S246 - S246   2014年9月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)  

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  • 肺動脈狭窄および右室圧上昇を伴うJatene術後妊婦の帝王切開術を硬膜外併用脊髄くも膜下麻酔で良好に管理し得た1例

    月永 晶人, 内本 一宏, 渕田 瑛, 朝倉 彩子, 後藤 隆久

    神奈川医学会雑誌   41 ( 2 )   307 - 308   2014年7月

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  • 胸腔鏡下肺上葉切除中に換気側肺に気胸を起こした一例

    江渕 慧悟, 山口 嘉一, 宮下 徹也, 後藤 隆久

    神奈川医学会雑誌   41 ( 2 )   306 - 306   2014年7月

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  • 動画で見る消化管ESDのさらなる工夫 食道ESDにおけるプロポフォール・デクスメデトミジン併用静脈麻酔の有用性に関する検討

    野中 敬, 宮下 徹也, 有本 純, 松浦 瑞恵, 日暮 琢磨, 飯田 洋, 遠藤 宏樹, 古出 智子, 高橋 宏和, 芝田 渉, 稲森 正彦, 中島 淳, 前田 愼, 後藤 隆久

    Progress of Digestive Endoscopy   85 ( Suppl. )   s83 - s83   2014年6月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会-関東支部  

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  • The distinct roles of hypoxia-activated transcription factors in atelectasis-induced lung injury: a pro-inflammatory role of nuclear factor-kappa B and an anti-inflammatory role of hypoxia-inducible factor-1 in lung epithelial cells

    K. Tojo, N. Yusuke, T. Yazawa, T. Mihara, T. Goto, K. Kurahashi

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY   31   1 - 1   2014年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)  

    Web of Science

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  • Which provides better postoperative recovery af ter laparoscopic surgery, fentanyl or remifentanil?

    A. Asakura, T. Mihara, T. Goto

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY   31   4 - 5   2014年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)  

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  • Disrupted cortical function underlies behavior dysfunction due to social isolation (vol 122, pg 2690, 2012)

    Tomoyuki Miyazaki, Kenkichi Takase, Waki Nakajima, Hirobumi Tada, Daisuke Ohya, Akane Sano, Takahisa Goto, Hajime Hirase, Roberto Malinow, Takuya Takahashi

    JOURNAL OF CLINICAL INVESTIGATION   124 ( 6 )   2807 - 2807   2014年6月

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  • ポスト・ポリオ症候群患者に対する全身麻酔管理の経験

    北澤 みずほ, 横瀬 真志, 内本 一宏, 後藤 隆久

    臨床麻酔   38 ( 4 )   657 - 659   2014年4月

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    記述言語:日本語   出版者・発行元:真興交易(株)医書出版部  

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  • 低流量麻酔の注意点

    川上裕理, 後藤隆久

    臨床麻酔(真興交易)   38 ( 臨増 )   275 - 285   2014年3月

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    記述言語:日本語   出版者・発行元:真興交易(株)医書出版部  

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  • 分離肺換気中の非換気側肺において無気肺に伴う低酸素が炎症を惹起する

    東條 健太郎, 長嶺 祐介, 矢澤 卓也, 後藤 隆久, 倉橋 清泰

    臨床呼吸生理   46   47 - 47   2014年2月

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    記述言語:日本語   出版者・発行元:臨床呼吸生理研究会  

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  • 輪状甲状間膜穿刺に超音波プレスキャンが有用であった頸部仮性動脈瘤破裂の1症例

    大和田 玄, 伊奈川 岳, 中村 京太, 刈谷 隆之, 後藤 隆久

    麻酔   63 ( 1 )   77 - 80   2014年1月

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  • 腫瘍随伴性天疱瘡患者における開腹腫瘍生検術の麻酔経験

    吉田 輔, 山口 嘉一, 高野 俊博, 木下 充子, 倉橋 清泰, 後藤 隆久

    日本臨床麻酔学会誌   33 ( 6 )   S321 - S321   2013年10月

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  • 予測効果部位濃度を指標として麻薬を投与したにも拘らず抜管後PaCO2の上昇を来した一例

    江渕 慧悟, 倉橋 清泰, 後藤 隆久

    日本臨床麻酔学会誌   33 ( 6 )   S249 - S249   2013年10月

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  • ポスト・ポリオ症候群患者に対する全身麻酔管理の経験

    北澤 みずほ, 横瀬 真志, 吉岡 征夫, 後藤 隆久

    日本臨床麻酔学会誌   33 ( 6 )   S215 - S215   2013年10月

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  • 吸入麻酔薬 キセノン麻酔について 利点、欠点、将来の展望

    水原 敬洋, 後藤 隆久

    日本臨床麻酔学会誌   33 ( 5 )   736 - 741   2013年9月

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    記述言語:日本語   出版者・発行元:日本臨床麻酔学会  

    DOI: 10.2199/jjsca.33.736

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    その他リンク: http://search.jamas.or.jp/link/ui/2014007073

  • Is ramosetron superior to ondansetron? 査読

    Mihara T, Goto T

    Paediatric anaesthesia   23 ( 5 )   464   2013年5月

  • Nasal high flowが有効であった呼吸不全の一例

    前島 英恵, 速水 元, 水谷 健司, 塩田 将, 高木 俊介, 山口 嘉一, 増淵 哲仁, 出井 真史, 上野 歌奈子, 後藤 隆久

    日本集中治療医学会雑誌   20 ( Suppl. )   405 - 405   2013年1月

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  • 腫瘍摘出後に重篤な循環不全を呈した巨大褐色細胞腫の一例

    長嶺 祐介, 西成田 玲子, 倉橋 清泰, 上野 歌奈子, 前島 英恵, 高木 俊介, 塩田 将, 水谷 健司, 速水 元, 後藤 隆久

    日本集中治療医学会雑誌   20 ( Suppl. )   426 - 426   2013年1月

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  • 感染性心内膜炎術後、持続的中心静脈圧高値を認め上大静脈症候群と診断された1症例

    上野 歌奈子, 速水 元, 水谷 健司, 塩田 将, 刈谷 隆之, 高木 俊介, 山口 嘉一, 前島 英恵, 出井 真史, 後藤 隆久

    日本集中治療医学会雑誌   20 ( Suppl. )   374 - 374   2013年1月

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    記述言語:日本語   出版者・発行元:(一社)日本集中治療医学会  

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  • 横浜市立大学手術部における手術室災害訓練の経験

    佐藤仁, 川上裕理, 刈谷隆之, 後藤隆久

    日本臨床麻酔学会誌   33 ( 4 )   539-544 (J-STAGE) - 544   2013年

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    記述言語:日本語   出版者・発行元:THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA  

    【背景】横浜市立大学附属病院手術室では,2006年まで,年に1度手術室をクローズして避難訓練を行っていた.これは主に火災を想定し職員の避難に重点を置いた訓練であった.この年,病院の災害対策マニュアル整備をきっかけに,手術室独自の災害対策マニュアル作成が行われた.このマニュアルは実際に機能するのか検証し,その不備を改善する目的で,災害に主眼を置いた訓練が企画された.<br>  【訓練の実際】[2007年]マニュアルを使用した訓練を行うため,シミュレーショントレーニングの訓練形態を初めて採用した.具体的には机上訓練を用いてマニュアル検証を行った.[2008年]前年の反省点をふまえ改正されたマニュアルを再検証し,アクションカードや災害状況報告書,そのほか災害対策の物品を整理した.[2011年]2009年,2010年は,緊急時のトレーニングをシミュレーショントレーニング法で実施した.この経験を生かし,2011年は再度地震災害をテーマに,新しい訓練法を取り入れた.[2012年]これまでの経験を生かし,もう一つの大学病院である市民総合医療センターにて,この病院の特徴をふまえた災害訓練を行った.<br>  【訓練の成果と課題】・実際に使用しなければ明らかにできないマニュアルの問題点を改善できた./・多職種の参加者が共通認識を持つことができた./・実際に体験することで効率よく学習でき,実際の震災時もあわてることがないよう物品の面でも精神的な面でも準備を整えられた./・大規模な訓練の実施は時間的にもマンパワーの面でも困難であり,小規模なトレーニングを繰り返し行うことも必要であることが認識された.<br>  【結語】手術室災害トレーニングを繰り返し行い,効果的であったと思われるが,今後も継続していくために最適なトレーニング法を新たに模索する必要もあると考えられた.

    DOI: 10.2199/jjsca.33.539

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  • 手術室の災害対策 横浜市立大学手術部における手術室災害訓練の経験

    佐藤 仁, 川上 裕理, 刈谷 隆之, 後藤 隆久

    日本臨床麻酔学会誌   32 ( 6 )   S144 - S144   2012年10月

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  • 神経性食思不振症患者の麻酔経験

    豊原礼子, 山口嘉一, 宮下徹也, 寺端昭博, 後藤隆久

    神奈川医学会雑誌   39 ( 2 )   323   2012年7月

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  • 内視鏡手術における気道モニタリングの工夫

    刈谷隆之, 宮下徹也, 佐藤仁, 中村京太, 後藤隆久

    臨床モニター   23 ( Supplement )   35   2012年4月

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  • 【術前・術後管理必携】 周術期の一般管理 周術期の循環管理

    横瀬 真志, 後藤 隆久

    消化器外科   35 ( 5 )   538 - 542   2012年4月

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  • A reply

    Y. Koyama, M. Nishihama, G. Inagawa, Y. Kamiya, T. Miki, R. Kurihara, T. Goto

    Anaesthesia   67 ( 4 )   435 - 436   2012年4月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)  

    DOI: 10.1111/j.1365-2044.2012.07071_2.x

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  • くも膜下出血を機に大動脈縮窄症が発見された若年者の開頭クリッピング術の麻酔経験

    米川 裕子, 中橋 勇典, 水野 祐介, 紙谷 義孝, 武田 康二, 後藤 隆久

    麻酔   61 ( 3 )   326 - 328   2012年3月

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  • [A case of ruptured cerebral aneurysm associated with coarctation of the aorta].

    Yuko Yonekawa, Yusuke Nakahashi, Yusuke Mizuno, Yoshinori Kamiya, Kouji Takeda, Takahisa Goto

    Masui. The Japanese journal of anesthesiology   61 ( 3 )   326 - 8   2012年3月

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    A 15-year-old boy with subarachnoid hemorrhage was planned for emergency cerebral aneurysm clipping under general anesthesia. He had different blood pressure between the upper limbs and we found coarctation of the aorta at left subclavian artery bifurcation in the preoperative angiography. To prevent re-rupture of cerebral aneurysm and ischemia of abdominal organs, we monitored arterial blood pressure in bilateral radial arteries and non-invasive blood pressure in the left thigh, and his blood pressure was maintained within 120-150 mmHg of systolic pressure in the right radial artery and 50-70 mmHg of mean arterial pressure in the left radial artery and the left thigh during general anesthesia. The preoperative period elapsed uneventfully and the patient was planned for repair of coarctation of the aorta after discharge.

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  • 投与熱量算出に間接熱量計が有用であった病的肥満患者の1症例

    増渕 哲仁, 速水 元, 出井 真史, 中易 夏子, 塩田 将, 水谷 健司, 谷口 英喜, 後藤 隆久

    日本集中治療医学会雑誌   19 ( Suppl. )   326 - 326   2012年1月

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  • 全身麻酔下での呼吸様式の変化による心拍変動への影響

    大濱佐知, 宮下徹也, 後藤隆久

    日本臨床麻酔学会誌   31 ( 6 )   S465   2011年10月

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  • Comments on Comparison of Tracheal Intubation Using Airway Scope and Macintosh Laryngoscope in Patients With Simulated Limitation of Neck Movements Response

    Yoshihiro Aoi, Gaku Inagawa, Takahisa Goto

    JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE   69 ( 5 )   1309 - 1310   2010年11月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)  

    DOI: 10.1097/TA.0b013e3181f4e64f

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  • 酸素の投与方法とその評価 (特集 呼吸管理プラクティカルガイド) -- (呼吸管理の導入)

    後藤 隆久

    救急医学   34 ( 10 )   1166 - 1170   2010年9月

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    記述言語:日本語   出版者・発行元:へるす出版  

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    その他リンク: http://search.jamas.or.jp/link/ui/2011042645

  • Bleomycin(BLM)肺線維症マウスに対するKeratinocyte growth factor(KGF)発現アデノウイルスベクター投与の効果

    坂本 聖子, 馬場 靖子, 矢澤 卓也, 平井 豊博, 鐘ヶ江 裕美, 斎藤 泉, 後藤 隆久, 倉橋 清泰

    臨床呼吸生理   42   47 - 48   2010年6月

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    記述言語:日本語   出版者・発行元:臨床呼吸生理研究会  

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  • ガベキサートメシル酸塩を投与中に高カリウム血症を起こした1症例

    土井 智喜, 倉橋 清泰, 後藤 隆久

    麻酔   59 ( 2 )   249 - 251   2010年2月

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    記述言語:日本語   出版者・発行元:克誠堂出版  

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  • 【急性期栄養管理の基本と実際】 急性期栄養管理の施設独自の工夫 横浜市立大学における急性期栄養管理の実際

    長嶺 祐介, 大塚 将秀, 後藤 隆久

    救急医学   33 ( 13 )   1821 - 1823   2009年12月

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  • Successful intubation using a simple fiberoptic assisted laryngoscope for Treacher Collins syndrome: Correspondence

    Yasutsune Sugawara, Yasutsune Sugawara, Gaku Inagawa, Gaku Inagawa, Keiko Satoh, Keiko Satoh, Tatsuaki Kikuchi, Takahisa Goto

    Paediatric Anaesthesia   19   1031 - 1033   2009年10月

  • シミュレーションを利用した麻酔科後期研修医向け講習会の経験

    石山 美保, 中村 京太, 佐藤 仁, 川上 裕理, 後藤 隆久

    神奈川医学会雑誌   36 ( 2 )   315 - 315   2009年7月

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    記述言語:日本語   出版者・発行元:神奈川県医師会  

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  • 非心原性肺水腫 再膨張性肺水腫(REPE):普段からSpO<sub>2</sub>の低下に対する備えを常に頭に準備しておく

    水原敬洋, 後藤隆久

    Lisa   16 ( 6 )   548 - 550   2009年6月

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    記述言語:日本語  

    J-GLOBAL

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  • ACC/AHA非心臓手術のための周術期心血管系評価・管理ガイドライン2007:改訂解説

    原田 紳介, 伊奈川 岳, 後藤 隆久

    麻酔   58 ( 2 )   228 - 244   2009年2月

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    記述言語:日本語   出版者・発行元:克誠堂出版  

    CiNii Books

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    その他リンク: http://search.jamas.or.jp/link/ui/2009148051

  • 医師のストレス 麻酔科医のストレス

    宮下徹也, 後藤隆久

    医学のあゆみ   227 ( 2 )   111 - 115   2008年10月

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    記述言語:日本語   出版者・発行元:医歯薬出版  

    CiNii Books

    J-GLOBAL

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  • Anesthetic management of a patient with HOCM even after PTSMA 査読

    Fujimoto H, Kamiya Y, Ohki H, Goto T

    Japanese Journal of Anesthesiology   57 ( 10 )   1276 - 1279   2008年10月

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    記述言語:日本語   出版者・発行元:克誠堂出版  

    Scopus

    PubMed

    CiNii Books

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    その他リンク: http://orcid.org/0000-0001-9790-9867

  • 人工心肺やPCPSの適応について

    宮下徹也, 後藤隆久

    臨床麻酔(真興交易)   32 ( 5 )   917 - 920   2008年5月

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    記述言語:日本語  

    J-GLOBAL

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  • 酸素投与の方法と実践に役立つ知識 (特集 低酸素血症を考える)

    内本 一宏, 後藤 隆久

    救急医療ジャーナル   16 ( 1 )   20 - 23   2008年2月

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    記述言語:日本語   出版者・発行元:プラネット  

    CiNii Books

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    その他リンク: http://search.jamas.or.jp/link/ui/2008124002

  • 【麻酔 臨床工学技士として知っておくべき知識】 麻酔の歴史と作用機序

    大田 まりあ, 横瀬 真志, 渡邊 至, 後藤 隆久

    Clinical Engineering   19 ( 3 )   235 - 240   2008年2月

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    記述言語:日本語   出版者・発行元:(株)学研メディカル秀潤社  

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  • 開腹手術におけるIV‐PCAとPCEAによる術後鎮痛の有用性の比較検討

    内本一宏, 栗原理恵子, 宮下徹也, 菊地龍明, 後藤隆久

    J Anesth   22 ( Supplement (CD-ROM) )   P2-71-05   2008年

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    記述言語:日本語  

    J-GLOBAL

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  • 【ケース別救急診療のための緊急麻酔法 安全に!確実に!】 透析患者の緊急手術の麻酔と注意点

    横瀬 真志, 後藤 隆久

    救急・集中治療   19 ( 11-12 )   1549 - 1554   2007年12月

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    記述言語:日本語   出版者・発行元:(株)総合医学社  

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  • 抗リン脂質抗体症候群を合併した顎変形症患者の全身麻酔経験

    古瀬 智理, 紙谷 義孝, 岩井 俊憲, 相馬 理人, 渡貫 圭, 太田 信介, 松井 義郎, 後藤 隆久, 藤内 祝

    日本歯科麻酔学会雑誌 = JOURNAL OF JAPANESE DENTAL SOCIETY OF ANESTHESIOLOGY   35 ( 3 )   402 - 403   2007年7月

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    記述言語:日本語  

    CiNii Books

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  • β受容体遮断薬,α2受容体作動薬,スタチンの周術期投与と長期予後 (特集 集中治療・周術期管理と長期予後)

    水谷 健司, 後藤 隆久

    ICUとCCU   31 ( 7 )   482 - 488   2007年7月

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    記述言語:日本語   出版者・発行元:医学図書出版  

    CiNii Books

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    その他リンク: http://search.jamas.or.jp/link/ui/2008024602

  • The Airway Scope for difficult intubation

    Rieko Kurihara, Gaku Inagawa, Tatsuaki Kikuchi, Yukihide Koyama, Takahisa Goto

    Journal of Clinical Anesthesia   19   240 - 241   2007年5月

  • 新しい挿管器具Airway ScopeのコーマックIIIモデルを用いた挿管困難症例への有用性の検討

    小山行秀, 伊奈川岳, 宮下徹也, 菊地龍明, 三木智子, 後藤隆久

    J Anesth   21 ( Supplement (CD-ROM) )   P2-26-06   2007年

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    記述言語:日本語  

    J-GLOBAL

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  • Cornelia de Lange症候群患者の麻酔経験

    古瀬 智理, 斉藤 友克, 岩井 俊憲, 紙谷 義孝, 宮下 徹也, 松井 義郎, 後藤 隆久, 藤内 祝

    日本歯科麻酔学会雑誌   34 ( 5 )   526 - 527   2006年10月

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    記述言語:日本語   出版者・発行元:(一社)日本歯科麻酔学会  

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  • 人と麻酔器のインターフェース

    後藤 隆久

    日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia   26 ( 5 )   522 - 526   2006年9月

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    記述言語:日本語  

    CiNii Books

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  • クモ膜下出血後に喉頭軟化症様の上気道閉塞をきたした1症例

    安藤 瑞生, 後藤 隆久, 浅井 昌大, 藤田 正人, 福家 伸夫

    日本救急医学会雑誌   14 ( 9 )   463 - 466   2003年9月

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    記述言語:日本語   出版者・発行元:Japanese Association for Acute Medicine  

    Laryngomalacia, also known as flaccid larynx, is a common cause of stridor in the newborn. The supraglottic structures, such as the epiglottis, prolapse into the endolarynx with inspiration causing airway obstruction. This entity has recentry been reported as an acquired disorder. It can occur in patients who have lost laryngeal airway support becase of previous head and neck surgery, with progressive neurologic impairment or after head injury and coma. A case of a 47-year-old, previously healthy man presenting with a subarachnoid hemorrhage is described. Four days after a successful operation by a neurosurgeon, his severe inspiratory stridor prevented extubation. Examination with fiberoptic nasolaryngoscopy revealed subtotal airway obstruction due to epiglottis prolapse during inspiration. The patient was initially treated with NIPPV (non-invasive positive pressure ventilation), but was reintubated because of respiratory distress. Finally, he was extubated successfully after spontaneous resolution of the airway obstruction without any surgical laryngeal intervention.

    DOI: 10.3893/jjaam.14.463

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  • The cuffed oropharyngeal airway and management of the difficult airway - Reply

    S Uezono, T Goto, S Morita

    ANESTHESIOLOGY   90 ( 3 )   925 - 925   1999年3月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)  

    Web of Science

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  • フロンガスとオゾン層 (単著)

    後藤 隆久

    呼吸   18/,706-711   1999年

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  • 脳波による麻酔深度モニタリング(単著)

    後藤 隆久

    呼吸   18/1,24-28   1999年

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▼全件表示

共同研究・競争的資金等の研究課題

  • 高齢者における最適な手術後せん妄予防バンドルの開発と効果検証

    研究課題/領域番号:25K12151  2025年4月 - 2030年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    水原 敬洋, 後藤 隆久, 野間 久史, 東條 健太郎

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    配分額:4550000円 ( 直接経費:3500000円 、 間接経費:1050000円 )

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  • 大侵襲手術後PIICSの実態解明と予防的治療標的同定のための病態解析

    研究課題/領域番号:24K02539  2024年4月 - 2027年3月

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    後藤 隆久, 水原 敬洋, 杉浦 悠毅, 中村 謙介, 東條 健太郎, 高木 俊介

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    配分額:18590000円 ( 直接経費:14300000円 、 間接経費:4290000円 )

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  • ウエアラブルセンサーによる計測値に基く高齢者転倒リスク予測・予防モデル開発

    研究課題/領域番号:23K09576  2023年4月 - 2026年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    佐藤 仁, 後藤 隆久, 中村 京太, 中島 和江, 土屋 慶子, 北村 温美, 安部 猛, 川上 裕理

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

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  • 超音波ガイド下侵襲的処置時の術者負担軽減を目指した安全な超音波画像の提示法の開発

    研究課題/領域番号:21K10353  2021年4月 - 2024年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    川上 裕理, 後藤 隆久, 中村 京太, 佐藤 仁, 小松原 明哲, 安部 猛

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

    研究計画どおり、まず、シミュレーターによる計測環境を整備した。視点解析ソフトウエアであるiMotionをPCとともに購入し、シミュレーターを用いて中心静脈を穿刺する際の視点の移動の解析が可能となった。最初の解析の対象として、中心静脈穿刺の経験がほとんどない初期研修医を対象として、パイロットスタディーを実施した。この中で、超音波画像の中心静脈穿刺術野への画像の適切な投影法を、角度や画像の大きさ、プロジェクターでの解像度の設定、超音波機器との接続ケーブルの適正など検討し、実施法を確立した。計測時の台の高さと被験者の身長との関係を確認し、台の高さを適切に設定しなくては、視点解析時に被験者の視点が、測定可能範囲から外れてしまうことが判明したため、台の高さを適切に変更可能な手術台を使用して、身長との関係から適切な高さを設定できるよう測定環境の設定を確立した。また、初期研修医を対象にしたパイロットスタディーにおいて、穿刺の状況を画像に収録し、中心静脈穿刺中の視点解析以外の副次測定項目における定義を確立し、穿刺の成功、穿刺回数、超音波画像の描出の質、合併症の発生についてシミュレーション研究での測定プロトコルを確立した。現在は、初期研修医を対象とした実際のデータを5例収集し、さらにデータ数の集積をおこなっている。また、計画通り対象者を広げ、より中心静脈穿刺に熟練している麻酔科医への測定の準備を始めている。また、実際の臨床でのデータ収集を開始するための準備として、麻酔科医の中で中心静脈穿刺の経験の少ない医師と、経験の豊富な医師の手技をあらためて画像で検討し、プロジェクションマッピングによる穿刺法開発の基礎データを整理している。実際に穿刺針をどのように扱っているのか、どのように超音波画像を利用しているのかを明らかにし、今後の研究を推進する基礎データを収集している。

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  • メラトニン/ラメルテオン投与による術後睡眠障害予防効果の検討

    研究課題/領域番号:20K09201  2020年4月 - 2025年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    水原 敬洋, 後藤 隆久, 窪田 和巳, 東條 健太郎

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    配分額:4160000円 ( 直接経費:3200000円 、 間接経費:960000円 )

    本研究では,メラトニン/ラメルテオン投与により成人患者における術後睡眠障害が予防できるかどうかを検証する.研究の進め方は,第一段階としてメタ解析を行い,第二段階としてランダム化比較試験を行う予定である。
    第一段階として、本年度はメラトニン前投薬による術後覚醒時せん妄予防効果を検討する系統的レビュー・メタ解析の計画立案を行った。研究チーム内で系統的レビューの手順に関する議論を繰り返し、研究計画書を作成した。
    文献検索はMEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, Web of Scienceの4つの文献データベースおよび事前登録サイトとしてClinicalTrials. gov、WHO International Clinical Trials Registry Platform、UMIN Clinical Trials Registryから網羅的検索を行う計画とした。また、文献の選定・データの抽出用に適格基準とデータ抽出用紙を作成した。解析方法に関してはランダム効果モデルで統合するだけでなく、Trial Sequential Analysisも行う計画とした。これらの計画をUMIN事前登録するとともに、PRISMA-P(Preferred Reporting Items for Systematic Reviews and Meta- Analyses Protocols)声明に則り英文のプロトコル論文を執筆した。本プロトコル論文は査読を受けてBMJ Open誌に受理・掲載された。
    Tsukinaga A, Mihara T (Corresponding author), Takeshima T, Tomita M, Goto T, Yamanaka T. Effect of melatonin and melatonin agonists on postoperative sleep quality in adult patients: a protocol for systematic review and meta-analysis with trial sequential analysis. BMJ Open 2021;11:e047858.

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  • 敗血症モデルへの層別化メタボローム解析に基づくPICSメカニズム解明と治療法探索

    研究課題/領域番号:19H03753  2019年4月 - 2022年3月

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    後藤 隆久, 宮崎 智之, 杉浦 悠毅, 新倉 怜, 高瀬 堅吉, 東條 健太郎

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    配分額:17420000円 ( 直接経費:13400000円 、 間接経費:4020000円 )

    本研究の目標はラットを用いた敗血症後の中枢神経系post-ICU syndrome PICSモデルを構築し,脳における網羅的な代謝産物解析を行うことで,敗血症後の中枢神経PICSの病態メカニズム,新規治療法を探索することである。そのためにラットの敗血症後中枢神経PICSモデルの構築を目指して研究を行ってきた。前年度には10週齢Sprauge-Dawleyラットを用いて盲腸内容物懸濁液を用いた敗血症モデルを作成し,2週間後の段階でSocial Recognitionテスト,Inhibitory Avoidanceテストを施行したが,shamグループと比較して明らかな成績の低下が見られなかった。そこで,より長期的に炎症が継続する敗血症モデルとして盲腸結紮穿刺(CLP)モデルを作成した上で,2週間後の Inhibitory Avoidanceテストの成績をsham手術群と比較した。致死率は50%以上の敗血症モデルが作成できたものの,2週間後にはsham手術群と比較し有意な成績の違いは見られなかった。さらに,過去の報告においては系統の異なるWisterラットが用いられていたことから同じ様にCLPモデルを作成し,Inhibitory Avoidanceテストを行ったが,やはり2週間後にはsham手術群と比較して明らかな差異が見られなかった。これらの実験を踏まえると10週齢程度の若年ラットにおいては敗血症後の中枢神経系PICSは顕著ではないと考えられた。一方で,行動実験終了後の脳の組織ホモジネート中のサイトカイン濃度を測定したところ,sham手術群よりもIL-1βの増加が見られた。さらに,行動実験の成績によって動物をグループ分けすると,成績が悪いグループでIL-1βが有意に高い結果となった。これらから,若年ラットの敗血症において,脳の炎症が回復期の行動実験の成績悪化と関連している可能性が示唆されたが,中枢神経への影響の程度はそれほど大きくないということが示唆された。

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  • セボフルランによる抗不安効果発現の神経回路同定とその分子メカニズムの解明

    研究課題/領域番号:16H05459  2016年4月 - 2019年3月

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    後藤 隆久, 宮崎 智之, 内本 一宏, 新倉 怜, 高瀬 堅吉, 五嶋 良郎

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    配分額:17290000円 ( 直接経費:13300000円 、 間接経費:3990000円 )

    私たちの研究ではマウスに吸入麻酔薬濃度1.3 MACで2時間曝露し、その7日後に行動実験を行うプロトコルを採用してきた。この結果、セボフルランには活動性を向上させる作用があることが明らかとなった。セボフルランの抗不安作用が不安を示す動物に対して有効であるのかを調べるため、慢性浸水拘束ストレスモデル動物に対してのセボフルランの効果を検討することとした。当該モデルは1日2時間の拘束浸水を4日間連続で実施するものである。セボフルランの投与によりこの活動性の低下が軽減する傾向にあり、不安モデルにおいてセボフルランが抗不安効果を示すことが期待される。

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  • 麻酔科学と看護学を融合したアドバンスト周麻酔期看護過程プログラムの開発

    研究課題/領域番号:16K15877  2016年4月 - 2018年3月

    日本学術振興会  科学研究費助成事業  挑戦的萌芽研究

    赤瀬 智子, 後藤 隆久, 叶谷 由佳

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    配分額:3510000円 ( 直接経費:2700000円 、 間接経費:810000円 )

    外科手術の需要に伴い患者に対する安全で安楽な麻酔管理のため、質の高い周麻酔期看護師育成を目指し、麻酔科学と看護学を融合したアドバンスト周麻酔期看護過程プログラムを開発することが本研究の目的である。日本の周麻酔期看護師へのインタビューと関連職種である麻酔科医師、手術室看護師、看護職管理者にアンケート調査を実施した結果、医学と看護のバランスのとれた教育や手術室以外の麻酔業務に対応できる教育プログラムの必要性と海外の麻酔教育との比較から、臨床実習、シミュレーション教育における症例の充実と時間数増加の必要性が明確化し、さらに実践型・思考型教育過程プログラムの検討から有用な教育プログラムが開発できた。

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  • 性別、発達段階に応じたライフステージ依存性麻酔後効果の検討

    研究課題/領域番号:16K15678  2016年4月 - 2018年3月

    日本学術振興会  科学研究費助成事業  挑戦的萌芽研究

    後藤 隆久, 宮崎 智之, 高瀬 堅吉

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    配分額:3510000円 ( 直接経費:2700000円 、 間接経費:810000円 )

    申請者らは、吸入麻酔薬が高次脳機能に対して示す曝露後の効果に着目し、網羅的行動テストバッテリーを組み合わせて検討してきた。本課題では発達段階に応じたライフステージ依存性麻酔後効果の検討を実施した。アルツハイマー型認知症のモデル(APP-KI)および高齢マウスを用いて検証したところ、APP-KIでは多動、低不安(外界への認知力の低下)が見られたが、デスフルランの投与で多動が軽度抑制された。しかしながら総じてAPP-KIに対してデスフルランの影響は認められなかった。

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  • メラトニン前投薬による小児全身麻酔後の覚醒時せん妄予防効果

    研究課題/領域番号:15K20066  2015年4月 - 2019年3月

    日本学術振興会  科学研究費助成事業  若手研究(B)

    水原 敬洋, 駒崎 真矢, 何 廣頤, 中村 信人, 後藤 隆久

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    配分額:2340000円 ( 直接経費:1800000円 、 間接経費:540000円 )

    我々のメタ解析研究の研究により,メラトニンの麻酔前投薬による小児麻酔後覚醒時せん妄予防効果はプラセボと比較した場合にリスク比が0.31(95%信頼区間:0.16 - 0.60)であること,現在までのエビデンスの蓄積はいまだ不十分であり,確定的な結論を得るために必要な症例数の22%程度までしか集まっていないことが分かった.
    その後,ランダム化比較試験を遂行し,ラメルテオン0.1mg/kg前投薬による小児麻酔後覚醒時せん妄の予防効果はプラセボと比較した場合にリスク比が1.0(95%信頼区間:0.67から1.46, P>0.99)であり,効果を認めない事が分かった.

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  • 自動圧迫装置により測定した定量化毛細血管再充満時間によるショックの予測

    研究課題/領域番号:15K10989  2015年4月 - 2018年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    森村 尚登, 後藤 隆久, 坂本 哲也, 大井 康史, 酒井 拓磨, 佐藤 公亮, 野垣 文子, 篠原 真史, 松本 順, 安部 猛, 藤井 裕人, 土井 智喜, 六車 崇, 春成 伸之, 伊巻 尚平, 竹内 一郎

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

    パルスオキシメータの原理を応用して爪床圧迫前後の近赤外光と赤色光の透過光変化から定量化した毛細血管再充満時間(Q-CRT)ならびに吸光度変化(ΔAb)と、血中乳酸値・敗血症との関連を検討した。救急外来内因性疾患例で、乳酸値≧2mmol/L群は<2mmol/L群に比して有意にΔAb値が低く、高乳酸血症予測の感度は64%、特異度は75%であった。敗血症予測におけるQ-CRTのカットオフ値は3.3秒、感度55%、特異度82%。予測精度はq-SOFAと同等で、SIRSよりも高い特異度を示した。ΔAbは高乳酸血症の診断に優れた指標であり、Q-CRTは敗血症予測の有用なパラメータであることが示された。

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  • 吸入麻酔薬曝露後の記憶学習能に関するメカニズムの網羅的解析

    研究課題/領域番号:15K10517  2015年4月 - 2018年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    伊奈川 岳, 後藤 隆久, 内本 一宏, 宮崎 智之, 水原 敬洋, 朝倉 彩子

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

    若年雄性Sprague-Dawleyラットにデスフルラン(0.7および1.2 MAC)で2時間麻酔した場合,1.2 MAC群で,対照群と比較し,曝露1日目に海馬依存性文脈的記憶学習の障害を認めたのに対し,0.7 MACでは認めなかった.また曝露後3日目おおよび7日目には学習障害を認めなかった.曝露1日目に1.2 MAC群では対照群と比較し,海馬LTPも抑制され,IA刺激によるGluR1発現も抑制されていた.
    以上より,若年成体ラットに比較的濃度の高いデスフルラン曝露をすると,AMPA受容体のtrafficking が阻害され,曝露1日後に可逆的な記憶学習障害を生じることを認めた.

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  • 多面的記憶テストバッテリーを用いた麻酔薬の記憶忘却作用の検討

    研究課題/領域番号:26670691  2014年4月 - 2016年3月

    日本学術振興会  科学研究費助成事業  挑戦的萌芽研究

    後藤 隆久

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    配分額:3640000円 ( 直接経費:2800000円 、 間接経費:840000円 )

    ミダゾラムには心的外傷後ストレス障害のフラッシュバックを減弱させる効果があることが報告されている。しかしながら、この効果が自律神経反応を低下させるのか、不快情動体験記憶そのものを忘却させるのかは不明であった。本研究では強い自律神経反射を伴わない課題であるモリス水迷路テストおよび物体再認テストを用いて、記憶そのものへのミダゾラムの効果を検討した。結果であるが、いずれの行動課題に対してもミダゾラムは効果を有さず、ミダゾラムの効果は過剰な自律神経反射の減弱によるものではないかと考えられた。

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  • 麻酔科医のメンタルヘルスの包括的改善策の検討

    研究課題/領域番号:25462445  2013年4月 - 2017年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    水谷 健司, 後藤 隆久, 保坂 隆

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    配分額:3900000円 ( 直接経費:3000000円 、 間接経費:900000円 )

    横浜市立大学附属の2病院を含む約20病院に所属する麻酔科医280名を対象に、うつ症状のスクリーニング調査を行ったところ、6.4%がメンタルヘルスのサポートが必要な状況と判断されたが、これは平成23年に行った全国調査における9.3%より少なかった。医局の産業医の存在が功を奏している可能性がある。平成28年度には、麻酔科医40名のうち半数に運動をするようにE-mail等で2週間の間、促し、その前後でうつ傾向の変化を調べた。運動を促す介入の有無によって差はなく、また万歩計で測定した2週間の総歩数とうつ傾向スコアリングの変化に相関関係はなかった。

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  • 網羅的行動テストバッテリーを用いた麻酔薬の新規効能探索

    研究課題/領域番号:25293330  2013年4月 - 2016年3月

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    後藤 隆久, 宮﨑 智之, 内本 一宏, 高瀬 堅吉

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    配分額:18330000円 ( 直接経費:14100000円 、 間接経費:4230000円 )

    麻酔薬の中枢神経作用には、鎮静と言う主作用だけでなく、術後認知機能の低下など有害な副作用があることが知られている。これら副作用は、手術麻酔という状況から離れれば、臨床応用性を備えた主作用に転じる可能性を有している。本研究では、麻酔曝露を経験したマウスに網羅的行動テストバッテリーを課し、麻酔薬が脳高次機能に与える影響を検討した。その結果①イソフルランでは注意機能が障害される一方で、②デスフルランでは行動異常を誘導しなかった。また③セボフルランは抗不安作用を有することがわかった。

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  • 成体ラット開腹手術モデルを用いた急性侵害性疼痛による記憶学習能への影響の検討

    研究課題/領域番号:25462409  2013年4月 - 2016年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    小川 賢一, 内本 一宏, 後藤 隆久, 紙谷 義孝, 宮崎 智之, 水原 敬洋, 冨永 洋介, 朝倉 彩子, 弓場 由紀, 米崎 久美子, 足立 明子

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    配分額:4940000円 ( 直接経費:3800000円 、 間接経費:1140000円 )

    吸入麻酔薬を用いた全身麻酔手術後に生じる術後認知障害は,手術後の生存率と生活の質に悪影響を及ぼすことが知られている。本研究では下腹部開腹による術後疼痛モデルを作成し、遠隔期の文脈的記憶学習障害について検証を行ったところ、開腹術のみの侵襲では障害を生じない可能性が示唆された。また、5分間の吸入麻酔によって遠隔期に海馬AMPA受容体のシナプス発現量に変化を生じるが、開腹手術による侵害の影響は生じていない可能性が示唆された。これらは、臨床上の吸入麻酔薬の安全な使用法を開発していくうえで重要な知見であり、今後は遠隔期の認知記憶能の変化について、更なるデータの蓄積が必要と考えられる。

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  • 定量化した毛細血管再充満時間によるショックの予測

    研究課題/領域番号:24592742  2012年4月 - 2015年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    森村 尚登, 後藤 隆久, 坂本 哲也, 大井 康史, 松森 響子, 大塚 剛, 六車 崇

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    配分額:5460000円 ( 直接経費:4200000円 、 間接経費:1260000円 )

    パルスオキシメータの原理を応用して爪床圧迫前後の近赤外光と赤色光の透過光変化からCRTの定量化(Q-CRT)を試みた。健康成人の平均Q-CRT は 1.6秒であった。検者間測定値にばらつきをみとめたため、一定の陽圧で測定する指圧迫機構を開発した。併せて圧迫により発生する近赤外光と赤色光の差分の幅(ΔAb)が0.06より大きい場合に高い感度と特異度で2.0 mmol/l以上の乳酸値を予測することを示した。

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  • 全身麻酔後の記憶学習能変化とAMPA型グルタミン酸受容体の関与に関する研究

    研究課題/領域番号:24592308  2012年4月 - 2015年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    伊奈川 岳, 後藤 隆久, 内本 一宏, 高橋 琢哉, 宮崎 智之, 富永 洋介, 朝倉 彩子, 弓場 由紀, 米崎 久美子, 足立 明子

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    配分額:5330000円 ( 直接経費:4100000円 、 間接経費:1230000円 )

    本研究では、成体ラットに対する2時間の臨床用量のイソフルラン曝露によって,その遠隔期(麻酔薬曝露の数日後以降)に,空間認知を含む文脈依存的な記憶学習が障害され,海馬長期増強が抑制されることが示された.さらに海馬GluA1の再取り込み後のユビキチン結合が阻害される一方で、シナプスGluA1が過剰発現しており,シナプスの飽和現象が生じてAMAP受容体のtraffickingが抑制されている可能性が示唆された。またプロポフォール投与ではこれらの海馬の機能障害を認めなかったことから、術後認知記憶障害のリスク因子としては、吸入麻酔薬暴露が大きな要因を占めている可能性が示唆された。

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  • 麻酔科医のメンタルヘルスの現状と支援策に関する研究

    研究課題/領域番号:22591711  2010年 - 2012年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    後藤 隆久, 保坂 隆, 水谷 健司

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    配分額:4160000円 ( 直接経費:3200000円 、 間接経費:960000円 )

    全国の麻酔科医2500名を、日本麻酔科学会約10,000名より無作為に選び、2011年2月~3月と2013年2月~3月の2回にわたって、メンタルヘルスアンケート調査を行った。その結果、2011年には麻酔科医は、他の診療科なみに9.6%が中等度以上のうつ症状を呈し、また6.4%が死や自殺について週に数回以上考えていたが、2013年には中程度以上のうつ症状は6.4%へ、死や自殺の考えは4.4%に減少していた。従って、日本の麻酔科医のメンタルヘルスは過去3年間で改善したと考えられる。

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  • 老齢ラットにおける全身麻酔後の長期学習障害に関する基礎研究

    研究課題/領域番号:20591840  2008年 - 2010年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    伊奈川 岳, 後藤 隆久, 菊地 龍明, 西澤 絢子, 内本 一宏

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    配分額:4550000円 ( 直接経費:3500000円 、 間接経費:1050000円 )

    吸入全身麻酔薬イソフルランは、麻酔覚醒から数週間後でも認知機能を低下させることが、老齢動物を用いた実験で示されている。本研究では、8週齢ラットにおける、イソフルラン麻酔から覚醒後の空間記憶形成能の変化と、麻酔を行う時間が明期・暗期で効果が異なるかどうかを、行動学的手法を用いて研究を行った。ラットを麻酔群と非麻酔(対照)群それぞれに対して明期・暗期2群ずつの計4群に分け、麻酔覚醒後2日目から21日間、8方向放射状迷路を行った。結果は、測定した4項目のどれにおいても差は見られなかった。若年成熟ラットでは、イソフルラン麻酔後に空間記憶形成能は変化せず、明期・暗期のいずれに麻酔を行ったかでも影響されないことが示唆された。

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  • 術後高次脳機能障害に対するグルタミン酸NMDA受容体拮抗性麻酔薬の治療効果

    研究課題/領域番号:16591564  2004年 - 2006年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    後藤 隆久, 石黒 芳紀, 高田 真二, 坂本 英俊, 森田 茂穂, 花田 諭史

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    配分額:3400000円 ( 直接経費:3400000円 )

    本研究は、全身麻酔下にて3時間以上の腹部および整形外科大手術をうける60歳以上の患者を対象とし、グルタミン酸NMDA受容体拮抗作用が強い2種類の麻酔薬であるケタミンとキセノンが、術後認知機能低下を改善するという仮説を検証するための研究である。本年度は3年計画の研究の最終年にあたり、また研究代表者の後藤が帝京大学から横浜市立大学に異動したため、新しい患者のリクルートはなく、S-100β蛋白測定および術後データの取得と解析を行った。
    平成16年からの3年間で、合計65名の患者よりデータを得ることができた。亜酸化窒素+セボフルランで麻酔維持された対照群21名のうち6名で、術後2週間での認知機能低下を認めた。ケタミンを加えた群22名中7名、キセノン麻酔の群22名はそれぞれ4名であり、キセノンの方が少ない傾向にあったが、有意差には達しなかった。(ケタミンとキセノン群間でカイ二乗検定P=0.29)S-100βは3群で差を認めなかった。6ヵ月後の認知機能低下は対象群では17名中3名、ケタミンでは20名中4名、キセノンでは18名中2名であった。(ケタミンとキセノン群間でカイ二乗検定P=0.53)
    本研究は研究中に麻酔科における大量離職などの影響を受け、予定数より少ない患者数しかリクルートできず、検出力が不足したと考えられる。S-100β蛋白は低値で推移する患者がほとんどで、高次脳機能の研究を行うのにあまり適していない可能性が示唆された。それとは別に、キセノン群の患者の手術中に血圧低下が少なく、術後の回復が早い印象があった。これは今後の研究課題と考えている。

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  • 高齢者における手術後の高次脳機能低下の診断法と発生機序に関する研究

    研究課題/領域番号:12770839  2000年 - 2001年

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    後藤 隆久

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    配分額:2300000円 ( 直接経費:2300000円 )

    本研究では、50歳以上の高齢者を対象に、術後2週間目の高次脳機能をミニメンタルテスト(MMSE)、Wechsler成人知能テストのうちSymbol-digit置換テストとdigit-spanテストおよび事象関連電位のp-300で測定し、術前値と比較した。また手術中および術後に血中S-100蛋白を測定した。
    心肺バイパス(CPB)使用手術24例、非使用手術28例よりインフォームドコンセントを得た後、データを採取した。MMSEとdigit-spanは術前術後で変化はなかったが、symbol-digitはCPB使用患者で術後低下する傾向が見られた。しかし、データのばらつきが大きく、使用群と非使用群で変化率には有意差がなかった。P-300の潜時も術前と術後で有意な変化はみられなかった。また、p-300とMMSEなどの神経心理学テストの変化率との間に相関はなかった。
    S-100はCPB使用患者ではCPB終了直後に最高値となり、その中央値は1.42ng/ml(範囲0.58-4.16)であった。一方、非使用患者では手術直後に最高値をとったが、その中央値は0.32ng/ml(範囲0.05-1.49)と、CPB使用患者より有意に低かった。S-100濃度は上記のどの高次脳機能テストの変化率とも相関しなかった。
    S-100蛋白は脳神経損傷のマーカーとされる。この値が高次脳機能の変化と相関しないことより、術後の高次脳機能低下は神経の器質的損傷が原因ではないことが示唆される。また、心肺バイパス使用例のほうが神経損傷の程度が大きいことも示唆された。術後高次脳機能低下は、バルビツール酸などの神経保護薬では防止できないことが報告されているが、今回の結果はその理由を説明するものと考えられる。

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  • 脈波伝播動特性の解析による血管老化度の判定

    研究課題/領域番号:10671444  1998年 - 2000年

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    諏訪 邦夫, 石黒 芳紀, 後藤 隆久, 新見 能成, 森田 茂穂, 市瀬 史, 三枝 宏彰

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    配分額:3000000円 ( 直接経費:3000000円 )

    本研究が解析し,判明したことは以下の通りである.
    1)人工血管の脈波伝播速度が,通常人体の血管と比較して極端に高速であることを見出した.
    2)脈波伝播速度を簡便に測定する方法として,心電図のQRS波から指プレティスモグラフ(パルスオキシメーターを使用)の立ち上がりまでの時間を用いる法を開発して,その有用性を確認した.
    3)この手法をもちいて,脈波伝播速度が同一個体の同一部位でも状況によって変動しうる可能性を証明した.
    4)脈波伝播速度の解析において,従来は血管壁の厚みを無視してきたが,病態においては血管壁の厚みが無視できないことを仮説として提案し,理論的に解析した.
    5)脈波伝播の状況を種々のモデルで確認した.それによって,上記の壁の厚みと質量を無視すべきではないことを確認した.
    6)従来,種々の予測にもかかわらず脈波伝播速度が動脈硬化の診断に必ずしも役立っていない場合もある.その場合,血管壁が「硬くなる」だけでなくて,「重くなる」要因が加わっていることが原因であると結論した.

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  • 吸入麻酔薬としてのキセノンの鎮痛作用に関する基礎研究

    研究課題/領域番号:09877310  1997年 - 1998年

    日本学術振興会  科学研究費助成事業  萌芽的研究

    後藤 隆久, 田中 善規

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    配分額:1200000円 ( 直接経費:1200000円 )

    平成9年度に引き続き、吸入麻酔薬としてのキセノンガスの鎮痛効果について、ヒトを対象に研究を行った。なお、我々は、4年前より当施設の倫理委員会より許可を得て、キセノンを研究目的で臨床症例に用いている。
    手術予定患者よりインフォームドコンセントを得た後、キセノン70%+セボフルラン0.6%、キセノン50%+セボフルラン1.2%、亜酸化窒素70%+セボフルラン1.2%、またはセボフルラン2.6%(いずれも同じ麻酔深度)のいずれかで全身麻酔をかけ、手術開始時の皮膚切開前後の血行動態および血中カテコラミン濃度を測定し、各麻酔薬の鎮痛効果の指標とした。その結果、鎮痛効果がないとされるセボフルランのみの麻酔では、血圧と脈拍がともに約30-4%上昇したが、亜酸化窒素やキセノンを加えた群では15-20%の上昇に抑制された。
    また、キセノン50%、キセノン70%、亜酸化窒素70%のいずれかに様々な濃度のセボフルランを加え、血圧および脈拍が皮切前後で15%以上変化させないようにするセボフルランの濃度を求めたところ、キセノン50%と亜酸化窒素70%では等しく、キセノン70%ではそれより少量であることが判明した。
    以上の実験で、血中カテコラミンは血行動態変化と全く相関しないことも併せて判明した。また、この研究中、市販の麻酔用呼吸モニターに、キセノン使用により大きな誤差を出すものがあることが判明したので、これについて系統的に調べた。
    以上より、キセノンは亜酸化窒素と同等の鎮痛効果を持つことが明らかになった。しかし、キセノンは亜酸化窒素より催眠作用が強く、この点で亜酸化窒素より有利であると考えられる。

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  • 脊髄内神経可塑性における、グリシン抑制系の機能に関する研究

    研究課題/領域番号:08771233  1996年

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    後藤 隆久

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    配分額:800000円 ( 直接経費:800000円 )

    急性期の侵害刺激による中枢神経系ニューロンの感受性亢進(central sensitization)に対する脊髄内グリシン抑制系の修飾作用を調べた。
    ラットの足底部にホルマリンを皮下注する事によって誘導される疼痛は、注射直後の急性痛とその後に続く持続痛という二相性の時間経過をたどり、持続痛はNMDA受容体の活性化によるcentral sensitizationによることが知られている。グリシン受容体拮抗薬ストリキニ-ネをラットのくも膜下腔にホルマリン注射前に投与すると、急性痛、持続痛ともに亢進しる。しかし、ストリキニ-ネをホルマリン注射後、急性痛が終わり持続痛に移行する前に与えても、持続痛は亢進しない。この結果より次が示唆される。(1)グリシンは急性侵害刺激の入力を抑制している。いったんこの抑制がとれると侵害刺激が強く脊髄にはいるので急性痛のみならずcentral sensitizationも亢進する。(2)しかしcentral sensitizationが起こった後にストリキニ-ネを投与しても疼痛は亢進しないことより、NMDA受容体が活性化すると、グリシン抑制系からの脱抑制が起こるようである。
    これは、昨年度私が報告したGABA_A受容体によるcentral sensitizationの抑制作用と対照的である。電気生理学的にグリシンとGABA_Aによる抑制性電位の減衰時間がグリシンでは短くGABAでは長いことが知られているが、NMDA受容体を介する興奮性電位の減衰時間が急性痛のものに比べ長いことを考えると、グリシンよりGABAの抑制性電位のほうがNMDA受容体の興奮性電位に拮抗するのに適していると考えられ、今回の結果と一致する。

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  • 中枢神経系の可塑性に対する、抑制性伝達物質GABAとグリシンの作用に関する研究

    研究課題/領域番号:07857105  1995年

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    後藤 隆久

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    配分額:900000円 ( 直接経費:900000円 )

    近年、持続性疼痛の原因として、急性疼痛による中枢神経系ニューロンの感受性亢進(central sensitization)の重要性が強調されている。今回、研究計画調書に記したように、central sensitizationに対する内因性GABAとグリシンの脊髄レベルでの修飾作用をラットを用いて調べた。
    ラットの足底部にホルマリンを皮下注することによって誘導される疼痛は、注射直後の急性痛とその後に続く持続痛という二相性の時間経過をたどり、急性痛は侵害刺激による直接刺激、持続痛はcentral sensitizationによることが知られている。GABAA受容体拮抗薬ビククリンをくも膜下腔に与えると、急性痛は何ら影響を受けないが持続痛は用量依存的に増加することが今回の研究で示された。これはAδやC線維は伝わってくる侵害刺激入力は、通常はGABAAの抑制下にはないが、いったんcentral sensitizationが起こると、内因性GABAによる抑制が誘導されることを示唆する。これは、炎症が中枢神経内の内因性GABAの量を増やすという他よりの報告と一致する。
    一方、GABAと並ぶ主要な中枢神経内抑制性伝達物質であるグリシンの受容体拮抗薬ストリキニ-ネは、急性痛が加わる前にくも膜下腔に与えておくと急性痛、持続痛を両方増強するが、持続痛が始まってから投与しても無効である。これは(1)GABAと異なりグリシンはsensitizationの起こっていない通常の状態で侵害刺激を抑制しているが、(2)central sensitizationが誘導されると、グリシン抑制系は機能しなくなることを示唆する。
    以上のように、本研究ではGABAとグリシンという二つの抑制性神経伝達物質が、侵害刺激入力の脊髄レベルでの処理に対し、対照的な作用をもっていることを世界で初めて示した。central sensitizationはNMDA型グルタミン酸受容体を介して誘導、維持されることが知られているので、次はNMDA受容体とGABAA、グリシン受容体との相互関係についてより詳細に調べる予定である。

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  • 心筋虚血と心タンポナ-デ

    研究課題/領域番号:06671553  1994年

    日本学術振興会  科学研究費助成事業  一般研究(C)

    森田 茂穂, 南部 隆, 照井 克生, 後藤 隆久, 新見 能成

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    配分額:1800000円 ( 直接経費:1800000円 )

    冠動脈狭窄による心筋虚血をもつ心臓にタンポナ-デが発生することは臨床上まれならずみられるが、その際心嚢内圧上昇の影響が正常心の場合と比較してどのように異なるかを、犬のモデルを用いて今回調べた。
    犬を全身麻酔、機械換気下に開胸し、冠動脈左回施技を狭窄して、その潅流領域の心筋収縮が狭窄前の70%まで落ちるように心筋虚血を作成した。
    心嚢内圧の上昇による血圧低下に対し輸液で対処することなく経過を観察すると、心筋虚血のある犬は、正常犬に比べ低い心嚢内圧でショック状態に陥ることが判明した。この理由として、心筋虚血をもつ犬は正常犬に比べもともと心拍出量が低いので、心嚢内圧上昇による実質的な前負荷の減少(前負荷=心室内圧-心嚢内圧)の影響が、大きな血圧低下につながりやすいことが考えられる。また、正常心にタンポナ-デが起きた場合、冠動脈血流は減少しないことが従来報告されているが、今回我々は、冠動脈狭窄の存在下では冠血流量が心嚢内圧の影響を受け減少し、その冠流域の心筋収縮能が低下することを初めて発見した。
    心タンポナ-デの病態生理の研究は、低圧系である右心系に従来焦点が当てられてきたが、今回の我々の研究は、左心系の心機能低下や虚血もタンポナ-デの病態に大きく影響することを示した。

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  • 中枢神経系の可塑性に起因する持続的疼痛に対する、全身麻酔薬の鎮痛作用の研究

    研究課題/領域番号:06857105  1994年

    日本学術振興会  科学研究費助成事業  奨励研究(A)

    後藤 隆久

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    配分額:900000円 ( 直接経費:900000円 )

    近年、持続性疼痛の原因として、急性疼痛による中枢神経系ニューロンの感受性亢進(central sensitization)の重要性が強調されている。今回、研究計画調書に記した様に、central sensitizationに対する全身麻酔薬の影響をラットを用いて調べた。
    ラットの足底部にホルマリンを皮下注することによって誘導される疼痛は、注射直後の急性痛とその後に続く持続痛という二相性の時間経過をたどり、持続痛はcentral sensitizationによることが知られている。静脈麻酔薬のペントバルビタールをホルマリン注射前に全身投与すると、持続痛が容量依存的に抑えられ、この効果はGABA_A受容体拮抗薬ピクロトキシンの同時投与によって拮抗される。また、ペントバルビタールを急性痛が引いた後、すなわちcentral sensitizationが誘導された後に投与すると、持続痛抑制効果が著しく減弱する。一方、ベンゾジアゼピン系麻酔鎮静薬ミダゾラムは、ペントバリビタールと同様GABA_A受容体を介して持続痛を抑制するが、その効果は急性痛が引いた直後にミダゾラムを投与した場合に最も大きいという点でペントバルビタールと異なる。
    以上より、ペントバルビタールとミダゾラムはいずれもGABA_A受容体を介してcentral sensitizationを抑制するが、ペントバルビタールはcentral sensitization誘導前投与が効果的で、いわゆるpreemptive analgesiaの作用を発揮するのに対し、ミダゾラムはむしろcentral sensitizationが誘導され始めてから投与した方が効果的である点が異なることが判明した。最後に、やはりGABA_A受容体作動性麻酔薬であるプロポフォールはcentral sensitizationに何ら影響しない。このように三つの異なるクラスのGABA_A受容体の多様性の現れとも考えることができる。

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社会貢献活動

  • 横浜市医療ICT研究会

    2016年4月

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    種別:その他

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