| 1. |
Tsukamoto M, Taura S, Kadowaki S, Hitosugi T, Miki Y, Yokoyama T., Risk Factors for Postoperative Sore Throat After Nasotracheal Intubation, Anesth Prog., doi: 10.2344/anpr-69-01-05., 69, 3, 3-8, 2022.09. |
| 2. |
Hitosugi T, Awata N, Miki Y, Tsukamoto M, Yokoyama T., Comparison of different methods of more effective chest compressions during cardiopulmonary resuscitation (CPR) in the dental chair, Resusc Plus. , doi: 10.1016/j.resplu.2022.100286. eCollection 2022 Sep., 2022 Aug 10;11:100286., 2022.08. |
| 3. |
Hirokawa J, Hitosugi T, Miki Y, Tsukamoto M, Yamasaki F, Kawakubo Y, Yokoyama T., The influence of electrocardiogram (ECG) filters on the heights of R and T waves in children.
, Scientific Report , doi: 10.1038/s41598-022-17680-4., 12, 1, 13279. , 2022.08. |
| 4. |
Masanori Tsukamoto, Izumi Kameyama, Riho Miyajima, Takashi Hitosugi, Takeshi Yokoyama
, Alternative Technique for Nasotracheal Intubation Using a Flexible Fiberoptic Scope., Anesthesia Progress, in press, 2022.06, In oral maxillofacial surgery, the endotracheal tube (ETT) is often inserted nasotracheally to allow surgeons to obtain a better view of and easily access to the oral cavity. Use of a flexible fiberoptic scope is an effective technique for difficult intubation. While the airway anatomy can be observed as the scope is advanced, the ETT tip cannot be observed with the traditional method. It is sometimes difficult to advance the ETT beyond the glottis as impingement of the ETT tip may occur.
We devised a new technique of nasotracheal intubation using a fiberoptic scope. In our technique the ETT and fiberoptic scope are inserted into the pharyngeal space separately through the right and left nasal cavities. This permits continuous observation of the glottis as the ETT is advanced into the trachea. The main advantage of this technique is that the tip of the ETT is visualized as the ETT is advanced which helps avoid impingement of the ETT. If resistance is noted, the ETT can easily be rotated or withdrawn without causing laryngeal damage, leading to safe and smooth intubation. This novel technique allows advancement of the ETT under continuous indirect vision, thus minimizing contact of the ETT with the laryngeal structures and aiding in unhindered passage into the glottis.
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| 5. |
Hitosugi T, Awata N, Miki Y, Tsukamoto M, Yokoyama T., A Comparison of Two Stool Positions for Stabilizing a Dental Chair During CPR.
,
Anesth Prog. , doi: 10.2344/anpr-68-03-13., 69, 2, 11-16, 2022.06. |
| 6. |
Naou Kunihiro , Masanori Tsukamoto, Shiori Taura, Takashi Hitosugi, Yoichiro Miki, Takeshi Yokoyama, Sevoflurane concentration for cannulation in developmental disabilities, BMC Anesthesiology, doi: 10.1186/s12871-022-01695-5., 22, 1, 148, 2022.05. |
| 7. |
Rumi Iwai, Takunori Shimazaki, Yoshifumi Kawakubo, Kei Fukami, Shingo Ata, Takeshi Yokoyama, Takashi Hitosugi, Aki Otsuka, Hiroyuki Hayashi, Masanobu Tsurumoto, Reiko Yokoyama, Tetsuya Yoshida, Shinya Hirono and Daisuke Anzai, Quantification and Visualization of Reliable Hemodynamics Evaluation Based on Non-Contact Arteriovenous Fistula Measurement, Sensors., https://doi.org/10.3390/ s22072745, 22, 2745, 2022.04, The condition of arteriovenous fistula (AVF) blood flow is typically checked by using auscultation; however, auscultation should require a qualitative judgment dependent on the skills of doctors, and further attention to contact infection is required. For these reasons, this study developed a non-contact and non-invasive medical device to measure the pulse wave of AVFs by applying optical imaging technology. As a first step toward realization of the quantification judgment based on non-contact AVF measurement, we experimentally validated the developed system, whereby the hemodynamics of 168 subjects were visually and quantitatively evaluated based on clinical tests. Based on the evaluation results, the fundamental statistical characteristics of the non-contact measurement, including the average and median values, and distribution of measured signal-to-noise power ratio, were demonstrated. The clinical test results contributed to the future construction of quantified criteria for the AVF condition with the non-contact measurement.. |
| 8. |
Naou Kunihiro, Masanori Tsukamoto, Shiori Taura, Takashi Hitosugi, Yoichiro Miki and Takeshi Yokoyama, Sevoflurane concentration for cannulation in developmental disabilities, BMC Anesthesiology, doi: 10.1186/s12871-022-01695-5, 22, 148, (2022) 22:148, 2022.05, Objective: The goal of this study was to compare the end-tidal sevoflurane concentration and time for intravenous cannulation at induction of anesthesia using sevoflurane with or without nitrous oxide in healthy children and in those with developmental disabilities.
Methods: Normal and developmentally disabled children were anesthetized by inhalation of sevoflurane with nitrous oxide or with nitrous oxide-free oxygen, and intravenous cannulae were introduced. Nitrous oxide was stopped after loss of consciousness. The following parameters were recorded for each patient: age, gender, height, weight, BMI, duration of intravenous cannulation, end-tidal concentration of sevoflurane at the completion of intravenous cannulation, and use of nitrous oxide. For each parameter except gender, p-value were calculated by one-way analysis of variance (ANOVA). For gender, p-value were calculated using the Fisher method. Two-way ANOVA was performed to evaluate the effect of patient health status and nitrous oxide use on the end-tidal concentrations of sevoflurane and the time required for intravenous cannulation.
Results: The end-tidal sevoflurane concentrations at the completion of the intravenous cannulation had received a significant main effect of the factor "the use of nitrous oxide" (F(1,166) = 25.8, p Conclusions: Between the healthy children and the children with developmental disabilities, no significant differences in the time required for the intravenous cannulation from the beginning of anesthetic induction. However, the end-tidal sevoflurane concentrations at the completion of the intravenous cannulation was significantly different. Sevoflurane in alveoli might be diluted by nitrous oxide.. |
| 9. |
＠Masanori Tsukamoto, Shiori Taura, Hitoshi Yamanaka, ＠Takashi Hitosugi, ＠Takeshi Yokoyama, Prediction of appropriate formula for nasotracheal tube size in developmental disability children, Clin Oral Investig
, PMID: 32804259 DOI: 10.1007/s00784-020-03517-9, 25, 4, 2077-2080, 2021.04, Objectives: Developmental disability children have differences in growth. Therefore, tube size selection is important for nasotracheal intubation. In our previous study for healthy children undergoing dental surgery, height was the most suitable factor to predict nasotracheal tube size. The aim of this study was to find the most suitable formula for selection of nasotracheal tube size for them, retrospectively.
Material and methods: Developmental disability children aged 2 to 10 years were included in this study. They were intubated nasotracheally from April 2012 until May 2017. Their actually intubated tube sizes were checked. The predicted tube sizes were calculated according to the formulas by the backgrounds: the diameter of the trachea at the 6th cervical (C6), 7th cervical (C7), and 2nd thoracic vertebrae (T2) in X-ray. The actually intubated tube sizes were compared with predicted sizes. Data were analyzed using Spearman's regression analysis.
Results: The tube sizes with 5.0, 5.5, and 6.0 mm ID were intubated in 75 patients. The age-based formula was the most suitable; the correlation coefficients (r2) were 0.9027 (vs age), 0.5434 (vs height), 0.3779 (vs weight), 0.0785 (vs C6), 0.2279 (vs C7), and 0.3065 (Th2) (p Conclusion: The age-based formula could be the most suitable for predicting nasotracheal tube size in developmental disability children aged 2 to 10 years. One smaller size by the age formula was most suitable at first trial tube.
Clinical relevance: The present data indicate that the selection of nasotracheal tube using one smaller size by the age formula (ID = 4 + age [years]/4) might be useful for developmental disability children.
Keywords: Developmental disability; Nasotracheal airway; Nasotracheal intubation; Tube size.. |
| 10. |
Takeshi Ifuku, Takashi Hitosugi , Yoshfumi Kawakubo, Tomoyuki Tanaka, Kazuto Doi, and Takeshi Yokoyama, Effective Method Using a Stool in Cardiopulmonary Resuscitation (CPR) on Dialysis Chair, Emergency Medicine International, https://doi.org/10.1155/2020/5691607, Volume 2020,, 2020.08, Background. Heart failure is the leading cause of death in dialysis patients. Cardiac arrest due to hypotension may also occur during dialysis therapy. If cardiac arrest is elicited, manual chest compressions (MCCs) should be started as soon as possible. However, all types of dialysis chairs are not stable for MCC, because there is no steady support between the backboard of the
dialysis chair and the floor. 'ese conditions may alter the effectiveness of MCC.
Methods. We investigated whether a round chair is effective in supporting the dialysis chair for MCC. Four adult males performed MCC on a mannequin placed on three dialysis chairs. MCC was performed in sets of 2 (each set was 100 times per minute) per person, with and without a round chair. A total of 4,800 compressions were performed by four executors.
Results. When the chair was not used as a stabilizer, the mean values of the fluctuation range were 20.8 ± 8.1 mm, 18.7 ± 5.5 mm, and 12.8 ± 1.8 mm, respectively. When the chair was used, the mean values of the fluctuation range were 6.1 ± 1.1 mm, 7.5 ± 2.1 mm, and 1.0 ± 0 mm, decreasing by 70%, 59%, and 92%. Conclusion. MCC performed with the stool under the backrest as a stabilizer was effective in supporting the dialysis chair.. |
| 11. |
Mizuno J, Otsuji M, Fukuoka Y, Tanaka Y, Ohishi M, Hata Y, Yokoyama T, Arita, H, Hanaoka K, Hybrid logistic function characterization of left ventricular pressure-time curve in left heart catheterization, Gazzetta Medica Italiana Archivio per le Scienze Mediche, DOI: 10.23736/S0393-3660.19.04036-1, 179, 5, 326-334, 2020.05, BACKGROUND: The left ventricular (LV) pressure-time curve (PTC) during one cardiac cycle in left heart catheterization includes much useful information for evaluating LV inotropism and lusitropism. Nonlinear regression analysis using the least-squares method is a valuable tool for elucidating the mechanism, summarizing information, eliminating noise, allowing speculation regarding unmeasured data, and separating the effects of multiple factors. We proposed that the isovolumic LV PTCs in some animal experiments have been presented with a hybrid logistic (HL) function which is the difference between two sigmoid logistic functions. In the present study, we applied some types of the HL function models for the clinical field and investigated which type of the HL function equation could precisely fit the LV PTCs in the human hearts.
METHODS: The 30 LV PTCs at 1 ms interval during one cardiac cycle in left heart catheterization in 10 patients were recorded and fitted with the four kinds of the HL function equations using the least-squares method;
P(t)=A/{1 + exp[-(4B/A)(t - C)]} - D/{1 + exp[-(4E/D)(t - F)]} + G (Eq. 1),
P(t)=A/{1 + exp[-(4B/A)(t - C)]} - D/{1 + exp[-(4E/D)(t - F)]} (Eq. 2),
P(t)=A/{1 + exp[-(4B/A)(t - C)]} - A/{1 + exp[-(4E/D)(t - F)]} + G (Eq. 3), and
P(t)=A/{1 + exp[- (4B/A)(t - C)]} - A/{1 + exp[-(4E/D)(t - F)]} (Eq. 4).
RESULTS: The mean correlation coefficients (r) of the best-fitted HL function curves with Eqs. 1, 2, 3, and 4 were 0.9983, 0.9977, 0.9979, and 0.9972, respectively. The r value of Eq. 1 was significantly largest among Eqs. 1-4.
CONCLUSIONS: The HL function model with seven parameters precisely fits the LV PTCs in the human hearts. The seven HL function parameters can reliably characterize the LV pressure and time course for evaluation of cardiac inotropism and lusitropism regardless of species.
KEY WORDS: Heart ventricles, pressure; Myocardial contraction; Cardiac catheterization. |
| 12. |
Masanori Tsukamoto, Hitoshi Yamanaka, Takashi Hitosugi, Takeshi Yokoyama, Endotracheal Tube Migration Associated With Extension During Tracheotomy, Anesth Prog., https://doi.org/10.2344/anpr-66-04-05, 67, 1, 3-8, 2020.04, Tracheotomy is occasionally performed to prevent postoperative airway obstruction especially for invasive surgical procedures involving head and neck cancer. When performed under general anesthesia, attention must be paid to avoid rupture of the tracheal tube cuff during the incision into the trachea. In this study, changes in the position of the endotracheal tube tip during extension of the head and neck for a tracheotomy were investigated. Twelve patients underwent placement of a tracheotomy during surgical procedures for oral cancer. After nasal intubation, the distance between the tube tip and the carina was measuring using a fiberoptic scope with the patient's head placed at an angle of 110°. Patients were repositioned for tracheotomy by placing a pillow under the shoulders and extending the head and neck at an angle of 140°. The distance measurements were subsequently repeated. The difference between the first and second measurements was calculated and analyzed statistically using a paired t test. On average the patients were 69.5 ± 9.0 years in age. The distance between the tube tip and the carina at an angle of 140° (3.6 ± 1.1 cm) was significantly longer than that at an angle of 110° (1.7 ± 1.0 cm) (p |
| 13. |
Hayashi K, Hitosugi T, Kawakubo Y, Kitamoto N, Yokoyama T., Influence of measurement principle on total hemoglobin value., BMC Anesthesiol., doi: 10.1186/s12871-020-00991-2., 20, 1, 81, 2020 Apr 7;20(1):81., 2020.04, Background: Total hemoglobin (tHb) measurement is indispensable for determining the patient's condition (hemorrhagic vs. ischemic) and need for blood transfusion. Conductivity- and absorbance-based measurement methods are used for blood gas analysis of tHb. For conductivity-based measurement, tHb is calculated after converting blood conductivity into a hematocrit value, whereas absorbance measurement is based on light absorbance after red blood cell hemolysis. Due to changes in plasma electrolytes and hemolysis, there is a possibility that conductivity- and absorbance-based measurement methods may cause a difference in tHb.
Methods: In this study, test samples with controlled electrolyte changes and hemolysis were created by adding sodium chloride, distilled water or hemolytic blood to blood samples collected from healthy volunteers, and tHb values were compared between both methods.
Results: Conductivity-based measurement revealed reduced tHb value (from 15.49 to 13.05 g/dl) following the addition of 10% sodium chloride, which was also reduced by the addition of hemolysate. Conversely, the addition of distilled water significantly increased tHb value than the expected value. In the absorbance method, there was no significant change in tHb value due to electrolyte change or hemolysis.
Conclusions: We have to recognize unexpected conductivity changes occur at all times when tHb is measured via conductivity- and absorbance-based measurement methods. The absorbance method should be used when measuring tHb in patients with expected blood conductivity changes. However, when using this method, the added contribution of hemoglobin from hemolytic erythrocytes lacking oxygen carrying capacity must be considered. We recognize that discrepancy can occur between conductivity- and absorbance-based measurement methods when tHb is measured.. |
| 14. |
Takunori SHIMAZAKI,Yoshifumi KAWAKUBO, Shinsuke HARA, Takashi HITOSUGI,
Takeshi YOKOYAMA, Yoichiro MIKI, Blood Leakage Determination Using the Chromaticity of a Color Sensor, Advanced Biomedical Engineering, DOI:10.14326/abe.8.177, 8, 177-184, Advanced Biomedical Engineering
8: 177–184, 2019., 2019.12. |
| 15. |
Kitamoto N, Hitosugi T, Kawakubo Y, Hayashi K, Yokoyama T., The measurement of blood pressure by the linear method compared to the deflation methods differently modifies the pulse oximeter alarm frequency., Blood Press Monit. 2020 Feb;25(1):13-17. , doi: 10.1097/MBP.0000000000000408., 25, 1, 13-17, 2019.12, BACKGROUND:
Noninvasive blood-pressure measurement device and pulse oximeter are important for patient monitoring. When these are placed on the same side, cuff inflation sometimes causes measurement failure by pulse oximeter.
OBJECTIVE:
The present study aimed to compare the pulse oximeter alarm frequency and pulse-wave disappearance duration between noninvasive blood-pressure measurement using the deflation method and that using the linear inflation method.
METHODS:
The study included 10 healthy subjects. The cuff for automatic sphygmomanometer was wrapped on one side of the upper arm and for pulse oximeter was attached to the thumb of the same side of upper limbs.
RESULTS:
The alarm frequency was 0 and 26% using the linear inflation and the deflation methods, respectively. Additionally, the pulse-wave disappearance duration was significantly longer using the deflation method than that using the linear inflation method (10.0 ± 1.5 vs 1.7 ± 0.8 s). With the linear inflation method, this duration was or less 3 s. In the deflation method, an excess pressure of 40 mmHg was used, which caused the alarm to turn on. Additionally, the heart rate was found to influence the alarm occurrence during measurement using the deflation method.
CONCLUSION:
Heart rate may influence alarm occurrence during blood-pressure measurement using the step deflation method. Using the linear inflation method, the risks of alarm occurrence and measurement failure are low, even when the pulse oximeter and blood-pressure measurement cuffs are installed on the same side, suggesting that this method is suitable for clinical use.. |
| 16. |
Tsukamoto M, Taura S, Hitosugi T, Yokoyama T., Comparison of the Performance of Mask Ventilation Between Face Masks With and Without Air Cushion., J Oral Maxillofac Surg. , doi: 10.1016/j.joms.2019.08.025., 77, 12, 2465.e1-2465.e5, 2019.12. |
| 17. |
Tsukamoto M, Taura S, Yamanaka H, Hitosugi T, Kawakubo Y, Yokoyama T., Age-related effects of three inhalational anesthetics at one minimum alveolar concentration on electroencephalogram waveform., Aging Clin Exp Res. inpress, doi: 10.1007/s40520-019-01378-1., 2019.10, BACKGROUND:
The characteristics of electroencephalogram (EEG) profiles under general anesthesia may depend on age and type of anesthetic.
AIM:
This study investigated age-related differences in EEG waveforms between three inhalational anesthetics used at the same minimum alveolar concentration (MAC), which indicates the level of analgesia.
METHODS:
Patients with American Society of Anesthesiologists physical status I-II were divided into three groups according to age: pediatric (≦ 15 years); adult (16-64 years); and elderly (≧ 65 years). Each group was divided into three subgroups according to the inhalational anesthetic used: sevoflurane, isoflurane, and desflurane. Anesthesia was maintained at 1 MAC, followed by assessment of 95% spectral edge frequency (SEF95) values and amplitude of EEG waveform.
RESULTS:
The 3 age groups comprised a total of 180 patients. The mean (± SD) EEG waveform amplitude and SEF95 values for sevoflurane in the pediatric, adult, and elderly age groups, respectively, were: 32.9 ± 2.9 µV and 16.7 ± 2.4 Hz; 16.4 ± 3.6 µV and 12.2 ± 1.3 Hz; and 11.0 ± 2.1 µV and 13.6 ± 1.6 Hz. EEG waveform amplitude and SEF95 values were significantly higher in the pediatric group than in the other groups. SEF95 value was higher in the elderly group than in the adult group. Similar results were obtained for isoflurane and desflurane.
CONCLUSION:
The amplitude of the EEG waveform and SEF95 values varied with age, even at the same analgesic state in patients under general anesthesia. This age-dependent change in EEG waveform was observed for all three inhalational anesthetics, and should be considered in procedures requiring general anesthesia.. |
| 18. |
Awata N, Hitosugi T, Miki Y, Tsukamoto M, Kawakubo Y, Yokoyama T., Usefulness of a stool to stabilize dental chairs for cardiopulmonary resuscitation (CPR)., BMC Emerg Med., 10.1186/s12873-019-0258-x., 19, 1, 2019.08, BACKGROUND:
Cardiopulmonary resuscitation (CPR) requires immediate start of manual chest compression (MCC) and defibrillation as soon as possible. During dental surgery, CPR could be started in the dental chair considering difficulty to move the patient from the dental chair to the floor. However, all types of dental chairs are not stable for MCC. We previously developed a procedure to stabilize a dental chair by using a stool. EUROPEAN RESUSCITATION COUNCIL (ERC) guideline 2015 adopted our procedure when cardiac arrest during dental surgery. The objective of this study was to verify the efficacy of a stool as a stabilizer in different types of dental chairs.
METHODS:
Three health care providers participated in this study, and 8 kinds of dental chairs were examined. MCC were performed on a manikin that was laid on the backrest of a dental chair. A stool was placed under the backrest to stabilize the dental chair. The vertical displacement of the backrest by MCC was recorded by a camcorder and measured by millimeter. Next, the vertical displacement of the backrest by MCC were compared between with and without a stool.
RESULTS:
In all 8 dental chairs, the method by using a stool significantly reduced the vertical displacements of the backrest by during MCC. The reduction ratio (mean [interquartile range]) varied between nearly 27 [20] and 87 [5] %. In the largest stabilization case, the displacement was 3.5 [0.5] mm with a stool versus 26 [5.5] mm without a stool (p CONCLUSIONS:
Our procedure to stabilize dental chairs by using a stool reduced the displacement of a backrest against MCC in all chairs.
CLINICAL RELEVANCE:
Effective MCC could be performed in dental chairs by using a stool when sudden cardiac arrest occurs during dental surgery.. |
| 19. |
Masanori Tsukamoto, Takashi Hitosugi, Takeshi Yokoyama, Comparison of recovery in pediatric patients: a retrospective study, Clinical Oral Investigations, 10.1007/s00784-019-02993-y, 2019.07, Objective The recovery after general anesthesia is influenced by the choice of inhalational agent. Stimulations might make patient’s agitate. However, the recovery using no touch technique might be safer. In this study, we compared the recovery time, awakening end-tidal concentration, and respiratory complications among inhalational anesthetics in pediatric patients using no touch technique, retrospectively.
Material and methods The subjectswere pediatric patients aged 3 months to 11 years under general anesthesia using sevoflurane, isoflurane, or desflurane. Background, awakening end-tidal concentration, respiratory complications, the time of eye open, body movement, and extubation were recorded.
Results A total of 170 patients were included in the study. There were no respiratory complications during emergence. Awakening end-tidal concentration in desflurane was 0.98%, sevoflurane (0.39%), and isoflurane (0.25%). In patients received
desflurane, the time of body movement, eye open, and extubation were significantly shorter than patients who received other anesthetics (p Conclusions The recovery from desflurane was significantly shorter among three inhalational anesthetics with no touch technique. In addition, no airway-related complication occurred.
Clinical relevance The recovery from desflurane might be useful to predict emergence by end-tidal inhalational concentration.. |
| 20. |
Tsukamoto M, Yamanaka H, Yokoyama T., Predicting the appropriate size of the uncuffed nasotracheal tube for pediatric patients: a retrospective study., Clin Oral Investig. , 23, 1, 493-495, 2019.01. |
| 21. |
Tsukamoto M, Yamanaka H, Yokoyama T., Age-related differences in recovery from inhalational anesthesia: a retrospective study., Aging Clin Exp Res., doi: 10.1007/s40520-018-0924-y., 30, 12, 1523-1527, 2018.12, INTRODUCTION:
It is important to understand the anesthetic requirements of elderly patients. However, little is known about age-related recovery from inhalational anesthetics. In this retrospective study, we compared age-related differences in recovery from three inhalational anesthetics in elderly subjects.
METHODS:
Patients were investigated as three age groups which can be defined as age ranges pediatric ( 65 years) under general anesthesia using inhalational anesthetics. Anesthesia and surgery times, drug end-tidal concentrations, the time to first movement, time to eye opening, body movement, extubation, and discharge were recorded. The data were analyzed using a Kruskal-Wallis test and Steel-Dwass multiple comparisons.
RESULTS:
A total of 594 patients were included in the study. In inhalational anesthetics such as sevoflurane, isoflurane, or desflurane, recovery from general anesthesia was not significantly different among age groups (P > 0.05). In inhalational group, recovery was significantly 5-40% faster in desflurane group than in other inhalational anesthetics groups (P CONCLUSION:
In the current study, we have found that recovery from desflurane was faster in younger patients than in other inhalational anesthetics and aged patients.. |
| 22. |
Yamanaka H, Tsukamoto M, Hitosugi T, Yokoyama T., Changes in nasotracheal tube depth in response to head and neck movement in children., Acta Anaesthesiol Scand. , doi: 10.1111/aas.13207. , 62, 10, 1383-1388, 2018.11. |
| 23. |
大島 優, 坂本 英治, 横山 武志, 口腔顔面痛患者に対する超音波エコーガイド下星状神経節ブロックの効果・合併症の検討, 日本歯科麻酔学会雑誌 , 46巻, 2号, 57-61, 2018.04, 頭頸部の慢性疼痛治療に星状神節ブロック(SGB)がしばしば用いられる。SGBにはまれであるが致死的合併症もある。安全性を高めるために、近年、超音波エコーガイド下のSGB(US-SGB)が実施されている。今回、従来どおりの盲目的SGB(Blind-SGB)とUS-SGBとで、その奏効性および合併症の出現について比較検討した。方法:当院で2013年9月から2017年12月までに施行されたSGB症例を対象とした。電子カルテから、年齢、性別に加え、効果発現、さらにSGB施行時の肩部への響き、嗄声、血管穿刺、腕神経叢ブロックといった合併症の有無の情報を抽出して、Blind-SGB群とUS-SGB群とで比較した。さらにUS-SGB群では局所麻酔薬(局麻薬)の広がる部位が頸長筋下に確認できた場合(ULC群)と、できなかった場合(non-ULC群)とで比較した。数量データはKruskal-Wallis検定で、カテゴリーデータはカイ二乗検定を行い、p値5%以下を有意とした。結果:対象期間内にBlind-SGB群79症例、US-SGB群69症例の情報を抽出した。ULC群が48症例で、non-ULC群が21症例であった。患者背景に有意な差はなかった。Blind-SGB群の効果発現は83.5%、US-SGB群は82.6%で、有意な差は認めなかったが、ULC群の効果発現が97.9%に対して、non-ULC群では47.6%と有意に低かった。合併症では血管穿刺の頻度に有意な差はなかったが、嗄声はUS-SGB群がBlind-SGB群に対して有意に少なかった。考察:US-SGBでは血管、神経と針先を確認しながら実施できる。さらに頸部交感神経幹がある頸長筋下に局麻薬の広がりを確認できた症例では高い確率で効果が認められた。US-SGBでは効果が高まるだけでなく、合併症を軽減できている。本研究からUS-SGBは、頸長筋下に局麻薬を注入できれば、より安全で効果の高い治療を患者に提供できることが示唆された。. |
| 24. |
Kanako Esaki, Masanori Tsukamoto, Eiji Sakamoto, Takeshi Yokoyama, Effect of preoperative oral carbohydrate therapy on perioperative glucose metabolism during oral–maxillofacial surgery: randomised clinical trial, Asia Pacific Journal of Clinical Nutrition, Asia Pacific Journal of Clinical Nutrition, 2017.11. |
| 25. |
Masanori Tsukamoto, Jun Hirokawa, T Yokoyama, Intraoperative fluid management in pediatric patients using bioelectrical impedance analysis during oral surgery, Pediatric Anesthesia and Critical Care Journal, 2017.11. |
| 26. |
Azusa Nakashima, Nakano Hiroyuki, Tomohiro Yamada, Tomoki Sumida, T Yokoyama, Katsuaki Mishima, Yoshihide Mori, The relationship between lateral displacement of the mandible and scoliosis, Journal of Oral and Maxillofacial Surgery, DOI 10.1007/s10006-016-0607-9, in press, 2017.11. |
| 27. |
I Morita, H Oyama, M Yasuo, M Toyot, Yoshinori Hayashi, T Yokoyama, N Kobayashi, Enantioselective Monoclonal Antibodies for Detecting Ketamine to Crack Down on Illicit Use, Biological and Pharmaceutical Bulletin, in press, 2017.11. |
| 28. |
Tomokazu Nagasawa, Yoshifumi Kawakubo, Keisuke Hayashi, Masanobu Tsurumoto, Norihisa Kitamoto, Masanori Tsukamoto, Takeshi Yokoyama., Comparing Data Analysis for Hemodynamic Monitoring in the Vigileo and LiDCORapid Models, International Journal of New Technology and Research (IJNTR), 3, 9, 114-120, International Journal of New Technology and Research (IJNTR)
ISSN:2454-4116, Volume-3, Issue-9, September 2017 Pages 114-120, 2017.09, Abstract— Currently, the standard method of cardiac output monitoring is to use a Swan-Ganz catheter. This catheter can lead to complications, and therefore the benefits over risks are being analyzed. In order to have a continuous monitoring of cardiac output or circulatory dynamics in a less invasive form, two different devices were developed. The first device that was developed is the Vigileo monitor (Vigileo) (Edwards Lifesciences corporation, CA, USA) and the second device is the LiDCORapid (Lidcolimited, London, UK). The comparison analysis of the cardiac output was measured between the Vigileo and LiDCORapid. A blood pressure calibrator made by BIO-TEK INSTRUMENTS called BIO-TEK601A was used for the artificial pressure source. Aortic pressure (Ao) and radial artery pressure (Rd) was obtained through the BIO-TEK601A. The CO was displayed from the data that was divided into each model, gender, age and input waveform. For statistical evaluation of the experimental data, Mann-Whitney U-test or Wilcoxon Signed rank sum test were used. The CO results from the Vigileo model were less dependent on the Ao or Rd pressure compared to the LiDCORapid model. The Vigileo was determined to have less variability with CO results compared to the LiDCORapid model.. |
| 29. |
S Sako, S Tokunaga, M Tsukamoto, J Yoshino, N Fujimura, T Yokoyama, Swallowing action immediately before intravenous fentanyl at induction of anesthesia prevents fentanyl-induced cough: a randomized controlled study, Journal of Anesthesia, DOI: 10.1007/s00540-016-2300-4, vol 31, No 2, 212-218, 2017.04. |
| 30. |
T Yokoyama, Takashi Hitosugi, Saori Koyama, Masanori Tsukamoto, Kanako Esaki, Low-dose carperitide (α-human A-type natriuretic peptide) alleviates hemoglobin concentration decrease during prolonged oral surgery: a randomized controlled study, Journal of Anesthesia, 325-329, 2017.03. |
| 31. |
Masanori Tsukamoto, Takashi Hitosugi, Kanako Esaki, Takeshi Yokoyama, Risk Factors for Postoperative Shivering After Oral and Maxillofacial Surgery, Journal of Oral and Maxillofacial Surgery, 74, 12, 2359-2362, 2016.12. |
| 32. |
Y Hayashi, S Morinaga, X Liu, J Zang, Wu Z, T Yokoyama, H Nakanishi, An EP2 Agonist Facilitates NMDA-Induced Outward Currents and Inhibits Dendritic Beading through Activation of BK Channels in Mouse Cortical Neurons., Mediators of Inflammation, 2016.11. |
| 33. |
Masanori Tsukamoto, Takashi Hitosugi, Kanako Esaki, Takeshi Yokoyama, Body composition and hemodynamics changes in special needs patients, J Dent Anesth Pain Med, 16, 3, 193-197, 2016.03. |
| 34. |
T Yokoyama, S Fujiwara, A Noguchi, U Imaizumi, Y Morimoto, KI Yoshida, S Ito, Masanori Tsukamoto, The effect of adrenaline or noradrenaline with or without lidocaine on the contractile response of lipopolysaccharide-treated rat thoracic aortas, Biomedical Research, 27, 2, 453-457, 2016.02. |
| 35. |
野口亨, 定松慎矢, 佐々野浩一, Takeshi Yokoyama, 無線ネットワークを利用した機器動作状況管理システムに関する研究, 日本手術医学会, 37, 1, 15-20, 2016.02. |
| 36. |
小林美和, 塚本真規, Takeshi Yokoyama, 経鼻挿管の固定に関する検討, 医療の質・安全学会, 11, 1, 5-10, 2016.01. |
| 37. |
SJFujiwara, K Tachihara, S Mori, K Ouchi, S Itakura, M Yasuda, Takashi Hitosugi, U Imaizumi, Y Miki, Toyoguchi I, Yoshida KI, T Yokoyama, Influence of the marvelous™ three-way stopcock on the natural frequency and damping coefficient in blood pressure transducer kits., Journal of Clinical Monitoring and Computing, 2016.12. |
| 38. |
S Fujiwara, K Tachihara, S Mori, K Ouchi, C Yokoe, U Imaizumi, Y Morimoto, Y Miki, I Toyoguchi, KI Yoshida, T Yokoyama, Effect of using a Planecta™ port with a three-way stopcock on the natural frequency of blood pressure transducer kits., J Clin Monit Comput. |
| 39. |
坂本 英治, 石井健太郎, 大島優, 中嶋康経, 江崎加奈子, 塚本真規, 一杉 岳, 横山武志, 非歯原性歯痛の診断までにうけた治療歴と医療費についての検討, 日本口腔顔面痛学会, 2016.01. |
| 40. |
Fujiwara S, Tachihara K, Mori S, Yamamoto T, Yokoe C, Imaizumi U, Morimoto Y, Miki Y, Toyoguchi I, Yoshida KI, Yokoyama T, Frequency characteristics of pressure transducer kits with inserted pressure-resistant extension tubes., Journal of Clinical Monitoring and Computing, 2017.11. |
| 41. |
Ju Mizuno, Mikiya Otsuji, Takeshi Yokoyama, Hideko Arita, Kazuo Hanaoka, Half-logistic function model for first half of descending phase of cardiomyocyte cytoplasmic Ca2+ concentration ([Ca2+]i)-time curve(CaTCIII) in isolated Aeqorin-injected mouse left vantricular papillary muscle, Acta Cardiologica Sinica, 32, 1, 65-74, 2016.01. |
| 42. |
Fujiwara S, Kawakubo, Yokoyama T, Effect of planecta and ROSE™ on the frequency characteristics of blood pressure-transducer kits., Journal of Clinical Monitoring and Computing, 10.1007/s10877-014-9650-y., 29, 6, 681-689, 2015.12. |
| 43. |
塚本 真規, 小林美和, Takeshi Yokoyama, 口腔外科手術における鼻孔縁褥瘡発生リスクの検討, 日本歯科麻酔学会雑誌, 43, 3, 351-354, 2015.07. |
| 44. |
Ito S, Karube N, Hirokawa J, Sako S, Yokoyama T, The Effect of the Use of a Stabilizer and Different Height Settings on the Stability of the Dental Chair when Performing High-Quality Chest Compressions, Emergency Medicine, 10.4172/2165-7548.1000268, 5, 4, 268, 2015.07. |
| 45. |
野口了, 佐々野浩一, 川久保芳文, Yokoyama T, 九州大学病院のME機器管理システムの現状と方向性, 日本手術医学会誌, 36, 2, 129-136, 2015.05. |
| 46. |
Hiroko Fujino, Shoko Itoda, Kanako Esaki, Masanori Tsukamoto, Saori Sako, Kazuki Matsuo, Eiji Sakamoto, Kunio Suwa, Takeshi Yokoyama, Intra-operative administration of low-dose IV glucose attenuates post-operative insulin resistance, Asia Pac J Clin Nutr , 10.6133/apjcn.2014.23.3.10, 23, 3, 400-407, 2014.09, Background & Aims: Insulin sensitivity often decreases after surgery in spite of normal insulin secretion, and may worsen the outcome. This post-operative insulin resistance increases according to the magnitude of surgical invasion. However, supplementation of carbohydrates before surgery attenuates the post-operative insulin re- sistance. This study aimed to investigate the effect of intra-operative administration of low-dose glucose on the post-operative insulin resistance. Methods: Patients undergoing maxillofacial surgery were randomly assigned to two groups throughout the surgical procedure: The glucose group receiving acetated Ringer solution with 1.5% glucose and the control group receiving acetated Ringer solution without glucose. Insulin resistance quantified by the mean glucose infusion rate (the glucose infusion rate) was evaluated by glucose clamp using the STG-22TM instrument on the previous day and on the next day of surgery. Blood glucose level was monitored continuously during surgery. In addition, serum insulin, ketone bodies and 3-methylhistidine were measured during periopera- tive period. Results: Patients in the glucose group (n=11) received 0.15±0.06 g/kg/h of glucose during surgery, while patients in the control group (n=11) received no glucose. In both groups, however, the mean blood glucose levels were maintained stable at less than 150 mg/dL during and after surgery. The serum ketone bodies signifi- cantly increased after surgery in the control group (p=0.0035), while it decreased significantly in the glucose group (p=0.043). The reduction rate in the glucose infusion rate was significantly lower in the glucose group, 43.320.7%, than that in the control group, 57.79.3% (p=0.041). Conclusions: Intra-operative small-dose of glucose administration may suppress ketogenesis and attenuate the post-operative insulin resistance without caus- ing hyperglycemia.. |
| 47. |
林 良憲, 古賀由佳, Xinwen Zhang, Christoph Peters, Yuchio Yanagawa, 武 洲, 横山 武志, 中西 博, Autophagy in superficial spinal dorsal horn accelerates the cathepsin B-dependent morphine antinociceptive tolerance., Neuroscience, 10.1016/j.neuroscience.2014.06.037., 275, 384-394, 2014.09, Opioids are the most widely used analgesics in the treatment of severe acute and chronic pain. However, opioids have many adverse side effects, including the development of antinociceptive tolerance after long-term use. The antinociceptive tolerance of opioids has limited their clinical use. A recent study has reported that autophagy is responsible for morphine-induced neuronal injury. However, little is known about the role of autophagy in morphine antinociceptive tolerance. In the present study, chronic morphine administration was found to induce the expression of autophagy-related proteins, including Beclin1 and microtubule-associated protein light chain 3 (LC3)-II, in GABAergic interneurons in the superficial layer (lamina I-II) of the spinal cord. A single intrathecal administration of autophagy inhibitors, 3-methyladenine (3MA) or wortmannin, inhibited the development of antinociceptive tolerance in a dose-dependent manner. Autophagy in the lamina I-II neurons was associated with increased level of cathepsin B (CatB), a lysosomal cysteine protease. The pharmacological blockade or gene deletion of CatB markedly prevented the development of morphine antinociceptive tolerance. Furthermore, the intrathecal administration of 3MA suppressed the upregulation of CatB 5 days after morphine administration. Finally, CatB deficiency inhibited the increased release probability of glutamate in the lamina I neurons after chronic morphine treatment. These observations suggest that the dysfunction of spinal GABAergic system induced by CatB-dependent excessive autophagy is partly responsible for morphine antinociceptive tolerance following chronic treatment.. |
| 48. |
Takeshi Yokoyama, Eiji Sakamoto, Fumiyasu Yamasaki, Koichi Yamashita, Tomoaki Yatabe, KunioSuwa, Remifentanil Has Sufficient Hypnotic and Amnesic Effect for Induction of Anesthesia by Itself, Open Journal of Anesthesiology, 4, 1, 8-12, 2014.01. |
| 49. |
今田 弘記, 怡土 信一, 塚本 真規, 横山 武志, 日帰り全身麻酔の術後合併症に影響を及ぼす要因の検討, 日本小児麻酔学会誌, 19, 1, 153-155, 2013.08, 2008年1月～2011年12月迄の4年間に管理した日帰り全身麻酔症例(0歳以上14歳以下)を対象に、帰宅許可を判断するための術後合併症を調査し、麻酔時間、麻酔維持方法、既往症との関連性について検討した。4年間の総症例数は208名(男128名、女80名、平均5.7±3.0歳)であった。診療科別症例数は小児歯科が最も多く、77.9%を占めた。既往歴は喘息36例、精神発達遅滞29例、薬剤・食物アレルギー29例であった。術式は多数歯齲蝕に対する歯科治療120例、上顎正中過剰埋伏歯抜歯47例、舌小帯強直症9例であった。術後合併症が発生した症例は43例で、飲水困難6例、排尿困難23例、ふらつき11例、嘔気・嘔吐3例であった。各々の術後合併症が発生した症例の平均麻酔時間は、発生しなかった症例に比べ長かったが有意差はなかった。術後合併症と麻酔維持薬に関係をみると、嘔気・嘔吐が認められたのは空気・酸素・セボフルラン(AOS)で維持した症例のみであった。既往歴のない症例と各々の既往を有する症例で、術後合併症の発生率に有意差はなかった。. |
| 50. |
Mizuno J, Otsuji M, Hanaoka K, Arita H, Yokoyama T, Intracellular Ca2+ transient Phase II can be assessed by half-Logistic function model in isolated aequorin-injected mouse left ventricular papillary muscle., Journal of Acta Cardiologica Sinica, in press, 2013.05. |
| 51. |
今田弘記, 怡土 信一, 塚本 真規, 横山 武志, Mallampati分類による気管挿管難易度の予測精度に関する検討, 日本口腔診断学会雑誌, 26, 1, 5-10, 2013.02, 術前のMallampati分類(M分類)による気管挿管難易度評価の予測精度について検討するため、九大病院において2006～2012年に施行された歯科治療および口腔外科手術で歯科麻酔科が管理した全身麻酔例のうち、M分類と気管挿管時Cormack-Lehane分類(C分類)による評価を行い、かつ喉頭鏡で喉頭展開を試み挿管した471例の麻酔記録とカルテを分析した。結果、M分類で挿管困難と予測された症例の割合は42%、C分類で挿管困難と評価されたのは9%であった。C分類で挿管困難と評価された症例のうち、M分類で挿管困難が予測できたのは73%であった。C分類で挿管が容易と評価された症例のうち、M分類でも挿管容易と予測されたのは61%であった。M分類で挿管が容易と予測された症例のうち、C分類でも容易と評価されたのは96%であった。M分類で挿管困難と予測された症例のうち、C分類でも困難と評価されたのは15%であった。. |
| 52. |
藤野寛子、伊藤田翔子、佐古沙織、松尾和樹、坂本英治、横山武志
, homeostasis model assessment-insulin resistance（HOMA-IR）法による周術期インスリン抵抗性評価の信頼性, 麻酔, 62, 2, 140-146, 2013.02. |
| 53. |
Yamanaka W, Takeshita T, Shibata Y, Matsuo K, Eshima N, Yokoyama T, Yamashita Y., Compositional stability of a salivary bacterial population against supragingival microbiota shift following periodontal therapy., PLoS One. , 2012;7(8):e42806., 2012.08. |
| 54. |
Hayashi Y, Kawaji K, Sun L, Zhang X, Koyano K, Yokoyama T, Kohsaka S, Inoue K, Nakanishi H., Microglial Ca(2+)-activated K(+) channels are possible molecular targets for the analgesic effects of S-ketamine on neuropathic pain., J Neurosci. , 31, 48, 17370-82, 2011.11. |
| 55. |
谷本千恵， 川久保芳文， 藤野寛子， 小林美和， 山田美香， 横山武志, 生体情報モニタのアラームに関する実態分析, 医療の質・安全学会誌, 6, 4, 467-474, 2011.10. |
| 56. |
Akihiro Mori, Peter Lee, Takeshi Yokoyama, Hitomi Oda, Kaori Saeki, Yohei Miki, Satoshi Nozawa, Daigo Azakami, Yutaka Momota, Yuki Makino, Takako Matsubara, Motohisa Osaka, Katsumi Ishioka, Toshiro Arai, Toshinori Sako, Evaluation of artificial pancreas technology for continuous blood glucose monitoring in dogs, J Artif Organs, 14, 2, 133-9, 2011.02. |
| 57. |
谷本千恵、川久保芳文、小林美和、内田桂子、山下悦子、藤野寛子、横山武志, 生体情報モニタのアラームの実態とアラームに対する意識調査, ハートナーシング, 24, 5, 534-9, 2011.01. |
| 58. |
Takashi Furuno, Fumiyasu Yamasaki, Takeshi Yokoyama, Kyoko Sato, Takayuki Sato, Yoshinori Doi, Tetsuro Sugiura, Effects of various doses of aspirin on platelet activity and endothelial function, Heart and Vessels, in press, 2010.07. |
| 59. |
Mizokami A, Tanaka H, Ishibashi H, Umebayashi H, Fukami K, Takenawa T, Nakayama KI, Yokoyama T, Nabekura J, Kanematsu T, Hirata M, GABAA receptor subunit alteration-dependent diazepam insensitivity in the cerebellum of phospholipase C-related inactive protein knockout mice, Journal of Neurochemistry 2010;114:302-10, 2010.05. |
| 60. |
Akinobu Imoto, Takeshi Yokoyama, Kunio Suwa, Fumiyasu Yamasaki, Tomoaki Yatabe, Reiko Yokoyama, Koichi Yamashita, Eva Sellden, Bolus oral or continuous enteral amino acids reduces hypothermia during anesthesia in rats
, Journal of Nutrition Science Vitaminology, 56, 2, 104-108, 2010.04. |
| 61. |
Ushida T, Yokoyama T, Kishida Y, Hosokawa M, Taniguchi S, Inoue S, Takemasa R, Suetomi K, Arai Y-CP, McLaughlin M, Tani T, Incidence and risk factors of postoperative delirium in cervical spine surgery, Spine , 34, 23, 2500-2504, 2009.11. |
| 62. |
Takeshi Yokoyama, Reiko Yokoyama, Satoshi Nomura, Satoshi Matsumoto, Ryoji Fujiyama, Syun-ichi Kiyooka, Synthesis of (S)-Ketamine via [1,3]-Chirality Transfer of a Stereocenter Created by Enantioselective Aldol Reaction, Bull. Chem. Soc. Jpn. , 82, 12, 1528-1532, 2009.09. |
| 63. |
Reiko Yokoyama, Satoshi Matsumoto, Satoshi Nomura, Takafumi Higaki, Takeshi Yokoyama, Syun-ichi Kiyooka, Enantioselective construction of nitrogen-substituted quaternary carbon centers adjacent to the carbonyl group in the cyclohexane ring: first asymmetric synthesis
of anesthetic (S)-ketamine with high selectivity, Tetrahedron, 65, 5, 5181-5191, 2009.05. |
