Updated on 2024/06/22

写真a

 
DEGUCHI Hiroyuki
 
Organization
University Medical and Dental Hospital Anesthesiology Assistant Professor
Title
Assistant Professor
External link

The Best Research Achievement in Research Career

Degree

  • Doctor of Philosophy ( 2021.3   Niigata University )

Research Interests

  • Motor-evoked potential

Research Areas

  • Life Science / Anesthesiology

Research History

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

    2024.5

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

    2022.4 - 2024.4

  • Niigata University   University Medical and Dental Hospital Anesthesiology   Assistant Professor

    2020.4 - 2022.3

 

Papers

  • Actions of remimazolam on inhibitory transmission of rat spinal dorsal horn neurons Reviewed

    Rintaro Hoshino, Nobuko Ohashi, Daisuke Uta, Masayuki Ohashi, Hiroyuki Deguchi, Hiroshi Baba

    Journal of Pharmacological Sciences   155 ( 2 )   63 - 73   2024.6

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

    DOI: 10.1016/j.jphs.2024.04.002

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  • Low-dose Droperidol Reduces the Amplitude of Transcranial Electrical Motor-evoked Potential: A Randomized, Double-blind, Placebo-controlled Trial. International journal

    Yusuke Mitsuma, Kenta Furutani, Hiroyuki Deguchi, Yoshinori Kamiya, Takahiro Tanaka, Nobutaka Kitamura, Hiroshi Baba

    Journal of neurosurgical anesthesiology   2021.8

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

    BACKGROUND: Low-dose droperidol has been reported to suppress the amplitude of transcranial electrical motor-evoked potentials (TCE-MEPs), but no randomized controlled trials have been conducted to assess this. This randomized, double-blinded, placebo-controlled trial aimed to test the hypothesis that low-dose droperidol reduced TCE-MEP amplitudes. METHODS: Twenty female patients with adolescent idiopathic scoliosis, aged between 12 and 20 years, and scheduled to undergo corrective surgery were randomly allocated to receive droperidol (20 µg/kg) or 0.9% saline. After recording baseline TCE-MEPs, the test drug was administered, following which TCE-MEP recordings were carried out every 2 minutes for up to 10 minutes. The primary outcome was the minimum relative TCE-MEP amplitude (peak-to-peak amplitude, percentage of baseline value) recorded in the left tibialis anterior muscle. Secondary outcomes included minimum relative MEP amplitudes recorded from all other muscle groups monitored in the study. Data are expressed as medians (interquartile range). RESULTS: The TCE-MEP amplitude of the left tibialis anterior muscle was significantly reduced following droperidol administration compared with saline (37% [30% to 55%] vs. 76% [58% to 93%], respectively, P<0.01). In the other muscles, the amplitudes were reduced in the droperidol group, except for the bilateral abductor pollicis brevis and the left quadriceps femoris muscles. The relative amplitude of the bilateral F waves recorded from the gastrocnemius was decreased in the droperidol group. CONCLUSIONS: Low-dose droperidol (20 µg/kg) reduced TCE-MEP amplitudes. Anesthesiologists should pay attention to the timing of droperidol administration during intraoperative TCE-MEP recordings, even if used in a low dose.

    DOI: 10.1097/ANA.0000000000000784

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  • A Bolus Dose of Ketamine Reduces the Amplitude of the Transcranial Electrical Motor-evoked Potential: A Randomized, Double-blinded, Placebo-controlled Study. International journal

    Kenta Furutani, Hiroyuki Deguchi, Mari Matsuhashi, Yusuke Mitsuma, Yoshinori Kamiya, Hiroshi Baba

    Journal of neurosurgical anesthesiology   33 ( 3 )   230 - 238   2021.7

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

    BACKGROUND: A low-dose bolus or infusion of ketamine does not affect transcranial electrical motor-evoked potential (MEP) amplitude, but a dose ≥1 mg/kg may reduce MEP amplitude. We conducted a randomized, double-blinded, placebo-controlled study to evaluate the effect of ketamine (1 mg/kg) on transcranial electrical MEP. METHODS: Twenty female patients (aged 12 to 18 y) with adolescent idiopathic scoliosis scheduled to undergo posterior spinal fusion were randomly allocated to receive ketamine or saline. General anesthesia was induced and maintained with continuous infusions of propofol and remifentanil. MEP was elicited by supramaximal transcranial electrical stimulation. MEP recordings were obtained at baseline and then at 2, 4, 6, 8, and 10 minutes after administration of ketamine (1 mg/kg) or saline (0.1 ml/kg). The primary endpoint was the minimum relative MEP amplitude (peak-to-peak amplitude, % of baseline value) recorded from the left tibialis anterior muscle. The baseline amplitude recorded before test drug administration was defined as 100%. RESULTS: Medians (interquartile range) minimum MEP amplitudes in the left tibialis anterior muscle in the ketamine and saline groups were 26% (9% to 34%) and 87% (55% to 103%) of the baseline value, respectively (P<0.001). MEP amplitudes in other muscles were significantly reduced by ketamine. The suppressive effect of ketamine lasted for at least 10 minutes in each muscle. CONCLUSION: A 1-mg/kg bolus dose of ketamine can reduce MEP amplitude. Anesthesiologists should consider the dosage and timing of intravenous ketamine administration during MEP monitoring.

    DOI: 10.1097/ANA.0000000000000653

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  • Propofol reduces the amplitude of transcranial electrical motor-evoked potential without affecting spinal motor neurons: a prospective, single-arm, interventional study.

    Hiroyuki Deguchi, Kenta Furutani, Yusuke Mitsuma, Yoshinori Kamiya, Hiroshi Baba

    Journal of anesthesia   35 ( 3 )   434 - 441   2021.4

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

    PURPOSE: Propofol inhibits the amplitudes of transcranial electrical motor-evoked potentials (TCE-MEP) in a dose-dependent manner. However, the mechanisms of this effect remain unknown. Hence, we investigated the spinal mechanisms of the inhibitory effect of propofol on TCE-MEP amplitudes by evaluating evoked electromyograms (H-reflex and F-wave) under general anesthesia. METHODS: We conducted a prospective, single-arm, interventional study including 15 patients scheduled for spine surgery under general anesthesia. Evoked electromyograms of the soleus muscle and TCE-MEPs were measured at three propofol concentrations using target-controlled infusion (TCI: 2.0, 3.0, and 4.0 µg/mL). The primary outcome measure was the left H-reflex amplitude during TCI of 4.0- compared to 2.0-µg/mL propofol administration. RESULTS: The median [interquartile range] amplitudes of the left H-reflex were 4.71 [3.42-6.60] and 5.6 [4.17-7.46] in the 4.0- and 2.0-μg/mL TCI groups (p = 0.4, Friedman test), respectively. There were no significant differences in the amplitudes of the right H-reflex and the bilateral F-wave among these groups. However, the TCE-MEP amplitudes significantly decreased with increased propofol concentrations (p < 0.001, Friedman test). CONCLUSION: Propofol did not affect the amplitudes of the H-reflex and the F-wave, whereas TCE-MEP amplitudes were reduced at higher propofol concentrations. These results suggested that propofol can suppress the TCE-MEP amplitude by inhibiting the supraspinal motor pathways more strongly than the excitability of the motor neurons in the spinal cord.

    DOI: 10.1007/s00540-021-02927-7

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  • Epidural Administration of Ropivacaine Reduces the Amplitude of Transcranial Electrical Motor–Evoked Potentials

    Kenta Furutani, Toshiyuki Tobita, Hideaki Ishii, Hiroyuki Deguchi, Yusuke Mitsuma, Yoshinori Kamiya, Hiroshi Baba

    Anesthesia & Analgesia   Publish Ahead of Print   2020.10

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    Publishing type:Research paper (scientific journal)   Publisher:Ovid Technologies (Wolters Kluwer Health)  

    DOI: 10.1213/ane.0000000000005236

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  • Low-dose droperidol suppresses transcranial electrical motor-evoked potential amplitude: a retrospective study International journal

    Hiroyuki Deguchi, Kenta Furutani, Yusuke Mitsuma, Yoshinori Kamiya, Hiroshi Baba

    Journal of Clinical Monitoring and Computing   35 ( 1 )   175 - 181   2020.2

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Springer Science and Business Media LLC  

    Low-dose droperidol has been widely used as an antiemetic during and after surgery. Although high-dose droperidol affects motor-evoked potential, the effects of low-dose droperidol on motor-evoked potential amplitude are unclear. The aim of this study was to investigate whether low-dose droperidol affects motor-evoked potential amplitude. We retrospectively reviewed the data of patients who underwent spine surgery under general anesthesia with motor-evoked potential monitoring from February 2016 to 2017. The outcome was the motor-evoked potential amplitude of the bilateral abductor pollicis brevis muscle, tibialis anterior muscle, and abductor hallucis muscle within 1 and 1-2 h after droperidol administration, compared with the baseline motor-evoked potential value. Thirty-four patients were analyzed. The median dose of droperidol was 21 µg/kg. The motor-evoked potential amplitudes of all muscles were significantly reduced after droperidol administration and recovered to baseline values within 2 h. The reduction of all motor-evoked potential amplitudes after droperidol administration was 37-45% of baseline values. There were no significant differences in other drugs administered. There were no serious adverse effects of droperidol administration. Motor-evoked potential amplitude was suppressed by low-dose droperidol. During intraoperative motor-evoked potential monitoring in spine surgery, anesthesiologists should pay careful attention to the timing of administration of droperidol, even at low doses. Based on the results of this study, we are conducting a randomized controlled trial.

    DOI: 10.1007/s10877-020-00464-4

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    Other Link: http://link.springer.com/article/10.1007/s10877-020-00464-4/fulltext.html

  • Marked attenuation of the amplitude of transcranial motor-evoked potentials after intravenous bolus administration of ketamine: a case report. International journal

    Kenta Furutani, Mari Matsuhashi, Hiroyuki Deguchi, Yusuke Mitsuma, Nobuko Ohashi, Hiroshi Baba

    Journal of medical case reports   12 ( 1 )   204 - 204   2018.7

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

    BACKGROUND: It is believed that ketamine does not affect motor-evoked potential amplitude, whereas various anesthetic drugs attenuate the amplitude of transcranial motor-evoked potential. However, we encountered a patient with marked attenuation of motor-evoked potential amplitude after intravenous bolus administration of ketamine. CASE PRESENTATION: A 15-year-old Japanese girl with a diagnosis of adolescent idiopathic scoliosis was admitted to our hospital to undergo posterior spinal fusion at T4-L3. After induction of general anesthesia using a continuous infusion of propofol and remifentanil, we confirmed that transcranial electrical motor-evoked potentials were being recorded correctly. Ketamine 1.25 mg/kg was administered intravenously for intraoperative and postoperative analgesia. About 3 minutes later, the motor-evoked potential amplitude was markedly attenuated. No other drugs were administered except for ketamine. The patient's vital signs were stable, and the surgery had not yet started. The motor-evoked potential amplitude was recovered at about 6 minutes after administration of ketamine. The surgery was performed uneventfully, and the patient had no neurologic deficit when she emerged from general anesthesia. CONCLUSIONS: Although there is a widely held belief in the field of anesthesiology that ketamine does not affect motor-evoked potential amplitude, it has been suggested that ketamine could affect its monitoring.

    DOI: 10.1186/s13256-018-1741-9

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Research Projects

  • 脊髄後角ニューロンにおけるレミマゾラムの鎮痛効果およびその作用機序の解明

    Grant number:22K16610

    2022.4 - 2024.3

    System name:科学研究費助成事業

    Research category:若手研究

    Awarding organization:日本学術振興会

    出口 浩之

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    Grant amount:\4680000 ( Direct Cost: \3600000 、 Indirect Cost:\1080000 )

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  • Elucidation of the mechanism of action of anesthetics in motor neuron in the spinal cord.

    Grant number:18K16441

    2018.4 - 2021.3

    System name:Grants-in-Aid for Scientific Research

    Research category:Grant-in-Aid for Early-Career Scientists

    Awarding organization:Japan Society for the Promotion of Science

    Deguchi Hiroyuki

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    Grant amount:\4030000 ( Direct Cost: \3100000 、 Indirect Cost:\930000 )

    Motor-evoked potential are one of the useful intraoperative neurophysiological monitoring to avoid permanent postoperative motor impairment. However, since motor-evoked potential is strongly affected by anesthetic agents, elucidation of their mechanism of action is important to improve the quality of monitoring interpretation. Propofol, which is considered to have relatively little effect and is frequently used, also suppresses the amplitude of motor-evoked potentials in a dose-dependent manner. However, its detailed mechanism of action is still unknown. In the present study, the mechanism of the suppression of motor-evoked potential amplitude by propofol was elucidated by simultaneously evaluating evoked EMG amplitude and motor-evoked potential amplitude, which are indices of motor neurons in the spinal cord excitability, in human subjects.

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