Updated on 2021/04/11

写真a

 
WATANABE Tatsunori
 
Organization
University Medical and Dental Hospital Uonuma Institute of Community Medicine Specially Appointed Lecturer
Title
Specially Appointed Lecturer
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Degree

  • 博士(医学) ( 2015.9   新潟大学 )

Research Interests

  • 術後鎮痛

  • 末梢神経ブロック

  • 薬物動態

  • フラビン蛋白蛍光イメージング

  • 麻酔

Research Areas

  • Life Science / Anatomy

  • Life Science / Pharmacology

  • Life Science / Clinical pharmacy

  • Life Science / Physiology

  • Life Science / Anesthesiology

Research History (researchmap)

  • Niigata University   地域医療教育センター魚沼基幹病院   Specially Appointed Lecturer

    2019.4

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  • Niigata University   Operation Center, Medical and Dental Hospital   Assistant Professor

    2016.2 - 2019.3

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  • Niigata University   Medical and Dental Hospital, Anesthesiology   Specially Appointed Assistant Professor

    2015.9 - 2016.2

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  • Niigata University   Brain Research Institute

    2011.4 - 2015.9

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  • Niigata University   Medical and Dental Hospital, Anesthesiology

    2010.8 - 2011.3

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  • 新潟県立中央病院

    2009.4 - 2010.7

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  • 長岡赤十字病院

    2008.4 - 2009.3

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  • Niigata University   Medical and Dental Hospital, Anesthesiology

    2007.4 - 2008.3

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  • Niigata University   Medical and Dental Hospital

    2005.4 - 2007.3

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Research History

  • Niigata University   University Medical and Dental Hospital UONUMA CHIIKI IRYO KYOIKU CENTER JUNBISHITU   Specially Appointed Lecturer

    2019.4

  • Niigata University   University Medical and Dental Hospital Operation Center   Assistant Professor

    2016.2 - 2019.3

  • Niigata University   University Medical and Dental Hospital Anesthesiology   Specially Appointed Assistant Professor

    2014.5 - 2016.1

Education

  • Niigata University   Brain Research Institute  

    2011.4 - 2015.9

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  • Niigata University   Faculty of Medicine   School of Medicine

    1999.4 - 2005.3

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Professional Memberships

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Papers

  • SUZYTM forceps facilitate nasogastric tube insertion under McGRATHTM MAC videolaryngoscopic guidance: A randomized, controlled trial. Reviewed International journal

    Kenta Furutani, Tatsunori Watanabe, Keiichiro Matsuda, Yoshinori Kamiya, Hiroshi Baba

    Medicine99 ( 41 ) e22545   2020.10

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    BACKGROUND: Nasogastric tubes can be easily inserted in patients under general anesthesia. However, for difficult cases, insertion techniques that can be used in routine clinical practice are limited. SUZY forceps are designed for the removal of pharyngolaryngeal foreign bodies under guidance of a McGrath videolaryngoscope. We hypothesized that using SUZY forceps under McGrath videolaryngoscopic guidance may facilitate nasogastric tube insertion and tested this in a randomized controlled trial. METHODS: Adult patients who underwent gastrointestinal or hepato-pancreato-biliary surgery were randomly allocated to 2 groups; the SUZY group and the Magill group. Patients, nurses, and all clinical staff except for the attending anesthesiologist were blinded to group assignment throughout the study. After anesthesia induction, insertion of the nasogastric tube was performed by skilled anesthesiologists with either SUZY or Magill forceps according to group allocation under McGrath videolaryngoscopic guidance. The primary endpoint was insertion time which was defined as the time required to advance the nasogastric tube by 55 cm from the nostril. Secondary endpoints were the success rates of the nasogastric tube insertion, which were defined as a 55-cm advancement from the nostril at the 1st, 2nd, and 3rd attempt, proper insertion rate, the severity of pharyngolaryngeal complications, and hemodynamic parameters during nasogastric tube insertion. RESULTS: Sixty patients were randomized and none of these patients were excluded from the final analysis. The median [interquartile range] insertion time was 25 [18-33] seconds in the SUZY group, and 33 [21-54] seconds in the Magill group (P = .02). Success rates were not different between the groups (97% and 80% in the SUZY and Magill group at 1st attempt, respectively, P = .10). Both, the severity score of the mucosal injury and the severity of sore throat were higher in the Magill than in the SUZY group, whereas the degree of hoarseness did not differ between the 2 groups. Hemodynamic parameters were not significantly different between the groups. CONCLUSION: Using SUZY forceps under McGrath videolaryngoscopic guidance reduced the time required to insert a nasogastric tube and the severity of pharyngolaryngeal complications, when compared to using Magill forceps.

    DOI: 10.1097/MD.0000000000022545

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  • Quadratus lumborum block type 2 for pedicle groin flap analgesia: a case report. Reviewed International journal

    Tatsunori Watanabe, Koji Moriya, Hiroshi Baba

    JA clinical reports6 ( 1 ) 36 - 36   2020.5

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  • Acute spatial spread of NO-mediated potentiation during hindpaw ischaemia in mice. Reviewed International journal

    Takeshi Onishi, Tatsunori Watanabe, Mika Sasaki, Yoshinori Kamiya, Masao Horie, Hiroaki Tsukano, Ryuichi Hishida, Tatsuro Kohno, Hirohide Takebayashi, Hiroshi Baba, Katsuei Shibuki

    The Journal of physiology597 ( 13 ) 3441 - 3455   2019.7

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    KEY POINTS: Neuropathic pain spreads spatially beyond the injured sites, and the mechanism underlying the spread has been attributed to inflammation occurring in the spinal cord. However, the spatial spread of spinal/cortical potentiation induced by conduction block of the peripheral nerves can be observed prior to inflammation. In the present study, we found that spreading potentiation and hypersensitivity acutely induced by unilateral hindpaw ischaemia are nitric oxide (NO)-dependent and that NO is produced by ischaemia and quickly diffuses within the spinal cord. We also found that NO production induced by ischaemia is not observed in the presence of an antagonist for group II metabotropic glutamate receptors (mGluRs) and that neuronal NO synthase-positive dorsal horn neurons express group II mGluRs. These results suggest strongly that NO-mediated spreading potentiation in the spinal cord is one of the trigger mechanisms for neuropathic pain. ABSTRACT: Cortical/spinal responses to hindpaw stimulation are bilaterally potentiated by unilateral hindpaw ischaemia in mice. We tested the hypothesis that hindpaw ischaemia produces nitric oxide (NO), which diffuses in the spinal cord to induce spatially spreading potentiation. Using flavoprotein fluorescence imaging, we confirmed that the spreading potentiation in hindpaw responses was induced during ischaemia in the non-stimulated hindpaw. This spreading potentiation was blocked by spinal application of l-NAME, an inhibitor of NO synthase (NOS). Furthermore, no spreading potentiation was observed in neural NOS (nNOS) knockout mice. Spinal application of an NO donor was enough to induce cortical potentiation and mechanical hypersensitivity. The spatial distribution of NO during unilateral hindpaw ischaemia was visualized using 4-amino-5-methylamino-2',7'-difluorofluorescein (DAF-FM). An increase in fluorescence derived from the complex of DAF-FM with NO was observed on the ischaemic side of the spinal cord. A similar but smaller increase was also observed on the contralateral side. Somatosensory potentiation after hindpaw ischaemia is known to be inhibited by spinal application of LY354740, an agonist of group II metabotropic glutamate receptors (mGluRs). We confirmed that the spinal DAF-FM fluorescence increases during hindpaw ischaemia were not observed in the presence of LY354740. We also confirmed that approximately half of the nNOS-positive neurons in the superficial laminae of the dorsal horn expressed mGluR2 mRNA. These results suggest that disinhibition of mGluR2 produces NO which in turn induces a spreading potentiation in a wide area of the spinal cord. Such spreading, along with the consequent non-specific potentiation in the spinal cord, may trigger neuropathic pain.

    DOI: 10.1113/JP277615

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  • Neural block therapy for radiation enteritis: a case report. Reviewed International journal

    Moegi Tanaka, Yoshinori Kamiya, Hiroki Shimizu, Tatsunori Watanabe, Natsuko Naito, Hiroshi Baba

    JA clinical reports5 ( 1 ) 20 - 20   2019.3

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    BACKGROUND: Radiation enteritis following radiotherapy targeting the abdomen occasionally causes ulcers or ileus, which can be difficult to treat and usually progressive and refractory, significantly degrading the patient's quality of life. CASE PRESENTATION: A 58-year-old woman had undergone surgery for cervical cancer approximately 21 years ago. During treatment, she had also received radiotherapy targeting the pelvis and stomach. She presented with complaints of vomiting and lower abdominal pain and was subsequently diagnosed with multiple gastric ulcers, enterocolitis, and paralytic ileus due to late radiation-induced sequelae. We reasoned that visceral sympathetic block would improve the abdominal symptoms; therefore, we performed a splanchnic nerve block and an inferior mesenteric artery plexus block. As predicted, these block procedures improved the symptoms. CONCLUSIONS: Radiation enteritis is an iatrogenic disease, and there is no established treatment for intractable cases. However, visceral sympathetic nerve block may show efficacy as a potential therapy for radiation enteritis-associated abdominal pain and ileus.

    DOI: 10.1186/s40981-019-0239-9

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  • Effect of remifentanil on postoperative nausea and vomiting: a randomized pilot study. Reviewed

    Tatsunori Watanabe, Koji Moriya, Naoto Tsubokawa, Hiroshi Baba

    Journal of anesthesia32 ( 5 ) 781 - 785   2018.10

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    Opioid-related postoperative nausea and vomiting should not occur following remifentanil administration because of its relatively short time to elimination. However, studies have indicated that the incidence of postoperative nausea and vomiting associated with remifentanil is similar to that with other opioids. Hence, we aimed to determine whether intraoperative remifentanil itself is associated with postoperative nausea and vomiting when postoperative pain is managed without opioid use. In this prospective pilot study, 150 patients who underwent unilateral upper limb surgery under general anesthesia with brachial plexus block were included. Patients in the remifentanil and control groups received 0.5 µg/kg/min remifentanil and saline, respectively. Postoperative pain was managed using a brachial plexus block, non-steroidal anti-inflammatory drugs, and acetaminophen. The presence of postoperative nausea and vomiting within the first 24 h after anesthesia was assessed by an evaluator blinded to patient allocation. Eight patients were excluded from the final analysis, resulting in 72 and 70 patients in the remifentanil and control groups, respectively. Postoperative nausea and vomiting within 24 h after surgery occurred in 11 and 9 patients in the remifentanil and control groups, respectively. These data suggest that remifentanil use only minimally affects the incidence of postoperative nausea and vomiting under sevoflurane anesthesia. UMIN Clinical Trials Registry identification number: UMIN000016110.

    DOI: 10.1007/s00540-018-2550-4

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  • Significant decreases in blood propofol concentrations during adrenalectomy for phaeochromocytoma Reviewed

    Tatsunori Watanabe, Haruhiko Hiraoka, Takuya Araki, Daisuke Nagano, Tohru Aomori, Tomonori Nakamura, Koujirou Yamamoto, Hiroshi Baba

    BRITISH JOURNAL OF CLINICAL PHARMACOLOGY83 ( 10 ) 2205 - 2213   2017.10

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    AIM
    The kinetics of propofol are influenced by cardiac output. The aim of this study was to examine changes in blood propofol concentrations during phaeochromocytoma surgery using target-controlled infusion (TCI) anaesthesia with propofol.
    METHODS
    This is a prospective observational study. Ten patients with phaeochromocytoma who underwent unilateral adrenalectomy were included. Cardiac output was measured using an arterial pressure-based cardiac output analysis method. The target blood propofol concentrations were adjusted to maintain an approximate bispectral index (BIS) value of 40 before initiating surgery. The settings remained constant during surgery. Blood samples for propofol concentrations were collected from the radial artery at seven time points: two before tumour manipulation (T1, 2), two during tumour manipulation (T3, 4), and three after tumour vein ligation (T4-7). BIS values, the arterial pressure cardiac index (APCI) and haemodynamic parameters were measured at the same time points as the blood samples. The prop-ratio was calculated by dividing blood propofol concentrations by target concentrations of TCI.
    RESULTS
    APCI increased during tumour manipulation and after tumour vein ligation. The prop-ratio was reduced significantly by approximately 40% and showed a significant negative correlation with APCI. BIS values increased significantly and showed a significant negative correlation with the prop-ratio.
    CONCLUSION
    The increased APCI during tumour manipulation and after tumour vein ligation was associated with markedly reduced blood propofol concentrations. These results reveal that significant decreases in the anaesthetic effect may be observed in patients undergoing phaeochromocytoma surgery even if TCI anaesthesia is used with propofol.

    DOI: 10.1111/bcp.13334

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  • Comparison of a curved forceps with a conventional straight forceps for nasogastric tube insertion under videolaryngoscopic guidance: A randomized, crossover manikin study. Reviewed International journal

    Kenta Furutani, Tatsunori Watanabe, Yoshinori Kamiya, Hiroshi Baba

    Medicine96 ( 35 ) e7983   2017.9

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:LIPPINCOTT WILLIAMS & WILKINS  

    BACKGROUND: Nasogastric tube (NGT) insertion is an easy procedure that can be routinely performed under general anesthesia. However, for difficult cases, there are limited insertion techniques available in routine clinical practice, considering the flexibility of NGTs. The SUZY curved forceps are designed for the removal of pharyngolaryngeal foreign bodies under guidance of the McGRATH MAC (McG) videolaryngoscope. Because McG enables clear visualization of the esophageal inlet, we hypothesized that the SUZY forceps can facilitate easier NGT insertion compared with the conventional Magill forceps under McG guidance and designed a randomized, crossover manikin study to test this hypothesis. MATERIALS AND METHODS: Ten anesthesiologists participated in this study. Each participant was instructed to insert an NGT using either the SUZY or the Magill forceps under McG guidance. Both types of forceps were used by each participant in a computer-generated random order. The primary outcome measure was the number of "strokes" (1 stroke was defined by a specific sequence of participant actions) required to advance the NGT 30 cm from the starting point. Data are expressed as medians (interquartile ranges [ranges]). RESULTS: The number of strokes required for NGT insertion was fewer in the SUZY group than in the Magill group {7 [7.0-12.5 (5-14)] vs 16.5 [13.5-20.3 (7-22)]; P <.05}. The time required for NGT insertion was also lesser in the SUZY group than in the Magill group {15.4 [13.7-20.0 (7.0-38.3)] seconds vs 30.3 [22.0-42.3 (12.8-47.5) seconds]; P <.05}. CONCLUSIONS: The SUZY curved forceps facilitated NGT insertion more effectively than the Magill straight forceps under McG guidance. Our results suggest that NGT insertion using the SUZY forceps under McG guidance is a secure and easy procedure.

    DOI: 10.1097/MD.0000000000007983

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  • Evaluation of the diagnostic accuracy of nonverbal signs used by medical staff to assess postoperative pain Reviewed

    Tatsunori Watanabe, Reiko Okawa, Tsuyoshi Sato, Andrey B. Petrenko, Hiroshi Baba

    EUROPEAN JOURNAL OF ANAESTHESIOLOGY34 ( 5 ) 318 - 320   2017.5

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    DOI: 10.1097/EJA.0000000000000572

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  • Risk factors for rescue analgesic use on the first postoperative day after upper limb surgery performed under single-injection brachial plexus block: a retrospective study of 930 cases. Reviewed International journal

    Tatsunori Watanabe, Koji Moriya, Takuya Yoda, Naoto Tsubokawa, Andrey B Petrenko, Hiroshi Baba

    JA clinical reports3 ( 1 ) 39 - 39   2017

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    Background: Postoperative pain management after upper limb surgery is important for preventing adverse events that can prolong hospital stay and cause readmission. This study aimed to identify the risk factors associated with rescue analgesic use on the first postoperative day after upper limb surgery performed under single-injection brachial plexus block (BPB). Findings: We retrospectively analyzed records from 930 patients who underwent upper limb surgery under a single-injection BPB. Postoperatively, patients were administered oral loxoprofen regularly and rescue analgesics when analgesia was insufficient. We assessed the association between patient, surgical information, and rescue analgesic use on the first day after surgery (from 7:00 PM on the day of surgery to 7:00 AM on the first postoperative day), using a logistic regression model. Multivariate analysis revealed a significant association between rescue analgesic use and bone surgery, in particular, osteotomy, ligament repair and reconstruction, osteosynthesis, treatment for an amputated digit, and surgical duration. Conclusion: Bone surgery (osteotomy, ligament repair and reconstruction, osteosynthesis, treatment for an amputated digit) and a longer operative time were risk factors for rescue analgesic use for treating postoperative pain after upper limb surgery performed under single-injection BPB.

    DOI: 10.1186/s40981-017-0110-9

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  • Perforation of the superior vena cava 5 days after insertion of a central venous catheter through the left internal jugular vein Reviewed

    Miyuki Kurabe, Tatsunori Watanabe, Tatsuro Kohno

    JOURNAL OF CLINICAL ANESTHESIA31   193 - 196   2016.6

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    We describe a very rare case of an indwelling central venous catheter (CVC) through the left internal jugular vein that perforated the superior vena cava (SVC) wall postoperatively, although the CVC was placed in the appropriate position preoperatively. Three days after CVC insertion, a chest radiograph showed that the CVC tip had moved from the lower SVC to the upper SVC. Five days after the insertion, computed tomography showed SVC perforation and the resulting hydrothorax. In cases of CVC insertion through the left side, the CVC tip should not be placed in the upper SVC (zone B). Considering individual clinical factors and the indwelling period for the CVC, the left innominate vein (zone C) may be a suitable site for the left-sided CVC tip to reduce the risk of SVC perforation. (C) 2016 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.jclinane.2016.02.002

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  • The utility of anatomic diagnosis for identifying femoral nerve palsy following gynecologic surgery Reviewed

    Tatsunori Watanabe, Masayuki Sekine, Takayuki Enomoto, Hiroshi Baba

    JOURNAL OF ANESTHESIA30 ( 2 ) 317 - 319   2016.4

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    We describe a case in which an anatomic diagnosis was useful for diagnosing and estimating the cause of femoral nerve palsy following gynecologic surgery. A 49-year-old female received general and epidural anesthesia for radical ovarian cancer surgery. Although injection pain was noted in the left medial shin with 1 % mepivacaine administered as a test dose, the catheter was left indwelling because it improved her symptoms. The surgery, which lasted 195 min, was performed in the lithotomy position, and a self-retained retractor was used to gain a good surgical field. Postoperatively, the patient complained of difficulty in stretching her knee joint and left lower limb paresthesia that did not improve after stopping continuous epidural administration. A spinal cord injury related to epidural anesthesia was suspected because the sites of sensory impairment and epidural injection pain were the same; however, the patient had greater weakness of the quadriceps muscle than the iliopsoas, and no other muscle weakness was observed. These findings and previous reports suggest that her femoral nerve palsy was caused by compression of the inguinal ligament from the self-retaining retractor and lithotomy position. Twenty months after surgery, her muscle strength had fully recovered.

    DOI: 10.1007/s00540-015-2113-x

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  • The effectiveness of combining remifentanil with propofol to achieve seizure adequacy in a patient undergoing modified electroconvulsive therapy Reviewed

    Tatsunori Watanabe, Kiyohiro Yoshinaga, Yutaro Suzuki, Toshiyuki Someya, Hiroshi Baba

    Japanese Journal of Anesthesiology64 ( 10 ) 1072 - 1075   2015.10

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    Language:Japanese   Publishing type:Research paper (scientific journal)   Publisher:Kokuseido Publishing Co. Ltd  

    A patient with medication resistant schizophrenia underwent modified electroconvulsive therapy (12 sessions). Propofol was chosen as a hypnotic agent and the adjustment of its dose and stimulus intensity was attempted. However, despite using propofol of a dose minimally required for hypnosis, adequate seizures could not be induced even with the maximum stimulation. Assuming that propofol was preventing the induction of seizures, it was decided to reduce its dose and at the same time to combine it with remifentanil 100 μg starting from the fifth session. This allowed to reach the seizure adequacy during the next and the four subsequent sessions. Although from the tenth session on, adequate seizures could no longer be induced (possibly due to the development of resistance to propofol), the patient's symptoms showed improvement after completion of all 12 sessions.

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  • Using lung ultrasound in an infant to detect bronchial intubation not previously identified by auscultation Reviewed

    Masataka Hiruma, Tatsunori Watanabe, Hiroshi Baba

    CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE62 ( 10 ) 1121 - 1122   2015.10

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    DOI: 10.1007/s12630-015-0400-5

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  • Spinal mechanisms underlying potentiation of hindpaw responses observed after transient hindpaw ischemia in mice Reviewed

    Tatsunori Watanabe, Mika Sasaki, Seiji Komagata, Hiroaki Tsukano, Ryuichi Hishida, Tatsuro Kohno, Hiroshi Baba, Katsuei Shibuki

    SCIENTIFIC REPORTS5   11191   2015.7

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:NATURE PUBLISHING GROUP  

    Transient ischemia produces postischemic tingling sensation. Ischemia also produces nerve conduction block that may modulate spinal neural circuits. In the present study, reduced mechanical thresholds for hindpaw-withdrawal reflex were found in mice after transient hindpaw ischemia, which was produced by a high pressure applied around the hindpaw for 30 min. The reduction in the threshold was blocked by spinal application of LY354740, a specific agonist of group II metabotropic glutamate receptors. Neural activities in the spinal cord and the primary somatosensory cortex (S-1) were investigated using activity-dependent changes in endogenous fluorescence derived from mitochondrial flavoproteins. Ischemic treatment induced potentiation of the ipsilateral spinal and contralateral S-1 responses to hindpaw stimulation. Both types of potentiation were blocked by spinal application of LY354740. The contralateral S-1 responses, abolished by lesioning the ipsilateral dorsal column, reappeared after ischemic treatment, indicating that postischemic tingling sensation reflects a sensory modality shift from tactile sensation to nociception in the spinal cord. Changes in neural responses were investigated during ischemic treatment in the contralateral spinal cord and the ipsilateral S1. Potentiation already appeared during ischemic treatment for 30 min. The present findings suggest that the postischemic potentiation shares spinal mechanisms, at least in part, with neuropathic pain.

    DOI: 10.1038/srep11191

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  • Ultrasound-guided supraclavicular brachial plexus block in a patient with a cervical rib Reviewed

    Tatsunori Watanabe, Kazuhito Yanabashi, Koji Moriya, Yutaka Maki, Naoto Tsubokawa, Hiroshi Baba

    CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE62 ( 6 ) 671 - 673   2015.6

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    DOI: 10.1007/s12630-015-0331-1

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  • Prolonged apnea, caused by remifentanil, during awakening from anesthesia for emergency ventriculoperitoneal shunt placement Reviewed

    Tatsunori Watanabe, Yoshiko Watanabe, Daisuke Takizawa, Haruhiko Hiraoka, Andrey B. Petrenko, Hiroshi Baba

    JOURNAL OF ANESTHESIA28 ( 2 ) 320 - 321   2014.4

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    DOI: 10.1007/s00540-013-1707-4

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  • Hypnotic Effect of Propofol and Hypothalamic Nuclei: Are We Barking Up the Right Neurocircuitry? Reviewed

    Andrey B. Petrenko, Tatsunori Watanabe, Hiroshi Baba

    ANESTHESIA AND ANALGESIA118 ( 2 ) 484 - 484   2014.2

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    Language:English   Publisher:LIPPINCOTT WILLIAMS & WILKINS  

    DOI: 10.1213/ANE.0000000000000025

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  • Efficacy of repeated subcostal transversus abdominis plane blocks with 0.2% lidocaine via 18-gauge intravenous catheters in patients undergoing abdominal aortic aneurism surgery Reviewed

    Goh Yamamoto, Tatsunori Watanabe, Takashi Fujiwara, Takashi Mochida, Ippei Watanabe, Tatsuro Kohno

    Japanese Journal of Anesthesiology63 ( 8 ) 866 - 871   2014

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    Language:Japanese   Publishing type:Research paper (scientific journal)   Publisher:Kokuseido Publishing Co. Ltd  

    Background : There is an increasing number of patients scheduled for abdominal aortic aneurysm resection in whom epidural anesthesia cannot be performed because of concomitant antiplatelet/anticoagulant therapy. Instead of epidural anesthesia for postoperative analgesia in such patients it is possible to use repeated bilateral subcostal transversus abdominis plane (TAP) blocks. Methods : Four patients receiving antiplatelet/anticoagulant therapy for abdominal aortic aneurysm resection under general anesthesia were studied. After the completion of surgery and before emergence from anesthesia 18-gauge intravenous catheters were inserted bilaterally into subcostal TAP and 100 ml (50 ml on each side) of 0.2% lidocaine with 1/500,000 epinephrine were injected via the catheters twice daily until the second postoperative day. Pain intensity was assessed using a 0-10 numerical rating scale at rest and during movement before and after each block. Results : Numerical pain ratings at rest and during movement decreased after each block, and good analgesia was obtained. No complications such as nausea, vomiting or infection were observed in the postoperative period. Conclusions : These findings suggest that repeated bilateral subcostal TAP blocks with 0.2% lidocaine performed via 18-gauge intravenous catheters provide good postoperative analgesia after abdominal aortic aneurysm resection.

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  • Safety and beneficial effects of spinal morphine on the postoperative course of elderly patients undergoing surgical fixation of the femoral neck fracture Reviewed

    Tatsunori Watanabe, Takashi Fujiwara, Takashi Mochida, Ippei Watanabe, Hiroshi Baba

    Japanese Journal of Anesthesiology62 ( 6 ) 665 - 699   2013.6

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    Background : We performed a retrospective study of the efficacy and safety of spinal anesthesia with 0.1 mg morphine in the postoperative course of elderly patients with femoral neck fracture. Methods : Sixty patients with ages averaging 84 years participated in this study. Surgery was performed under spinal anesthesia. Patients were assigned to either a group receiving of 0.1 mg morphine added to isobaric bupivacaine (Group M) or a group receiving of isobaric bupivacaine alone (Group B). The frequency of analgesic use and the occurrence of adverse side effects during the first 48 hours after surgery were compared between the two groups. Results : In the first 24 hours, the patients in Group M needed significantly less analgesics compared to Group B. The incidence of adverse side effects did not differ significantly between the groups, although nausea had a tendency to increase in Group M. One patient in Group M showed a mild decrease in oxygen saturation. Conclusions : The spinal administration of 0.1 mg morphine had beneficial effects and was safe in the postoperative period of elderly patients with femoral neck fracture provided that sufficient observation was given.

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  • Anesthetic management of a patient with a giant ovarian tumor containing 83 l of fluid Reviewed

    Keiko Bamba, Tatsunori Watanabe, Tatsuro Kohno

    SPRINGERPLUS2   487   2013

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:SPRINGER INTERNATIONAL PUBLISHING AG  

    We report the anesthetic management of a patient scheduled for tumor resection with a giant ovarian tumor containing 83 l of fluid. A 59-year-old woman [height 154 cm; weight 146 kg (ideal: 52 kg)] with a giant ovarian tumor was scheduled for tumor resection. Her preoperative abdominal circumference was 194 cm, which made supine positioning difficult. The thoracoabdominal computed tomography revealed a right giant cystic ovarian tumor with an estimated mass of 100 kg. Evidence of malignant tumor was not observed. In the operation room, she was intubated using a video laryngoscope (Airway Scope (R), Hoya, Tokyo, Japan) in a semirecumbent position under conscious sedation. Following general anesthesia, the tumor fluid was gradually aspirated at a rate of 500 ml/min, and during this procedure, spontaneous respiration was preserved with pressure support ventilation. After the fluid was drained, the tumor was resected in a supine position. There were no major perioperative complications in hemodynamic and respiratory status, such as supine hypotensive syndrome or re-expansion pulmonary edema. Her weight decreased to 50 kg postoperatively. Maintenance of spontaneous respiration and slow aspiration of the tumor fluid prevented respiratory and hemodynamic failure and resulted in safe anesthesia management during giant ovarian tumor resection.

    DOI: 10.1186/2193-1801-2-487

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  • Alternative site for median nerve blockade allowing early functional rehabilitation after hand surgery Reviewed

    Tatsunori Watanabe, Ippei Watanabe, Masahiro Koizumi, Andrey B. Petrenko, Hiroshi Baba

    CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE59 ( 1 ) 58 - 62   2012.1

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:SPRINGER  

    In this report we describe an alternative approach to catheter placement for continuous selective median nerve blockade. It spared the finger movements and therefore allowed early postoperative rehabilitation in a patient who underwent surgical repair of the index finger flexor tendon.
    A patient with a complicated history of traumatic index finger flexor tendon rupture, surgical repair, failed rehabilitation due to poor postoperative pain control, adhesion formation, and subsequent rerupture due to tenolysis was admitted for reconstructive surgery. This time, a continuous regional block was used. Although the insertion of a catheter at the wrist level would have spared the anterior interosseous branch of the median nerve and preserved finger movements, a more distant site had to be chosen to avoid proximity to the surgical wound. Therefore, under combined ultrasonography and neurostimulation guidance, the catheter was inserted in the proximal one-third of the patient's forearm distal to the branching-off point of the anterior interosseous nerve. Continuous ropivacaine infusion was initiated and maintained until being stopped on the afternoon of the third postoperative day, providing good analgesia without interfering with postoperative physiotherapy, which was successfully completed during this hospitalization.
    Placement of a catheter for continuous median nerve blockade in the proximal one-third of the forearm for effective postoperative pain-free rehabilitation after hand surgery should be considered in cases in which the surgical incision extends toward the patient's wrist. The block site can be readily identified by a combined use of ultrasonography and neurostimulation guidance.

    DOI: 10.1007/s12630-011-9613-4

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  • A case of sublingual hematoma following difficult laryngoscopy in a patient on anticoagulant therapy Reviewed

    Tatsunori Watanabe, Takashi Fujiwara, Misa Toyama, Takashi Mochida, Ippei Watanabe

    Japanese Journal of Anesthesiology60 ( 1 ) 100 - 103   2011.1

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    A 61-year-old man receiving anticoagulant therapy after the aortic valve replacement underwent emergency surgery for acute appendicitis. Although the patient was intubated with difficulty, no immediate complications were evident after extubation. On the evening of the first postoperative day he complained of a sore throat, difficulty in swallowing and dysphonia. The swelling of the tongue with right-side predominance and the swelling of the right neck were observed. The right-sided sublingual hematoma was confirmed by CT. The symptoms improved with steroid administration. The possibility of airway obstruction due to hematoma of the tongue should be considered in patients on anticoagulant therapy.

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  • A case of central cord syndrome following thyroidectomy Reviewed

    Tatsunori Watanabe, Daisuke Takizawa, Tsuyoshi Sato, Hisashi Masaki, Michiya Ohkuro, Toshiyuki Tobita, Hiroshi Baba

    JOURNAL OF CLINICAL ANESTHESIA22 ( 4 ) 307 - 309   2010.6

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    Language:English   Publisher:ELSEVIER SCIENCE INC  

    DOI: 10.1016/j.jclinane.2009.09.002

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Books

  • 続・末梢神経ブロックの疑問〜実践編〜Q&A70

    渡部達範( Role: Contributor)

    2018.11 

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  • 末梢神経ブロックの疑問Q&A70

    渡部達範( Role: Contributor)

    中外医学社  2017.11 

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  • 気道管理の疑問Q&A70

    渡部達範( Role: Contributor)

    中外医学社  2016.11 

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  • 新麻酔科研修の素朴な疑問に答えます

    渡部達範( Role: Contributor)

    メディカルサイエンスインターナショナル  2016.9 

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  • 気道管理に強くなる エビデンスに基づいた、確実に気道確保するための考え方・器具選び・テクニック

    渡部達範( Role: Contributor)

    羊土社  2016.5 

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  • 整形外科研修ノート 改訂第2版

    渡部達範( Role: Contributor)

    診断と治療社  2016.4 

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  • 臨床に役立つ神経障害性痛の理解 【痛みのScience & Practice 8】

    渡部達範( Role: Contributor)

    文光堂  2015.5 

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  • 超音波ガイド下末梢神経ブロック 実践24症例

    渡部達範( Role: Contributor)

    メディカル・サイエンス・インターナショナル  2013.5 

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Awards

  • 最優秀演題賞

    2014.6   一過性血流遮断によるしびれの脊髄機序: フラビン蛋白蛍光イメージング法を用いた解析

    渡部達範

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  • ポスター優秀賞

    2013.12   フラビン蛋白蛍光イメージング法を用いた一過性虚血後のしびれの脊髄機構の解析

    渡部達範

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Research Projects

  • なぜ神経障害性疼痛は傷害された末梢神経の支配領域を超えて広がるのか?

    Grant number:20H03775  2020.04 - 2023.03

    日本学術振興会  科学研究費助成事業 基盤研究(B)  基盤研究(B)

    馬場 洋, 倉部 美起, 渡部 達範, 大西 毅

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    Grant amount:\10660000 ( Direct Cost: \8200000 、 Indirect Cost:\2460000 )

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  • 神経障害性疼痛における脊髄・脳連関の生理学的解析およびグリア細胞活性化機構の解明

    2017.04 - 2020.03

    日本学術振興会  科学研究費(基盤研究B) 

    紙谷義孝

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    Grant type:Competitive

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  • フラビン蛋白蛍光イメージング法による神経ブロック後に生じる反跳痛の機序解明

    2017.04 - 2019.03

    日本学術振興会  科学研究費助成事業(若手研究B) 

    渡部達範

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    Authorship:Principal investigator  Grant type:Competitive

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  • カルシウム感受性蛍光タンパクを用いたスライス及びin vivo脊髄イメージング

    2015.04 - 2017.03

    日本学術振興会  科学研究費助成事業(挑戦的萌芽研究) 

    紙谷義孝

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    Grant type:Competitive

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  • フラビン蛋白蛍光イメージング法を用いた疼痛評価系の確立

    2015.04 - 2017.03

    日本学術振興会  科学研究費助成事業(若手研究B) 

    渡部達範

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    Authorship:Principal investigator  Grant type:Competitive

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