2024/06/22 更新

写真a

デグチ ヒロユキ
出口 浩之
DEGUCHI Hiroyuki
所属
医歯学総合病院 麻酔科 助教
職名
助教
外部リンク

代表的な業績

学位

  • 医学博士 ( 2021年3月   新潟大学 )

研究キーワード

  • 運動誘発電位

研究分野

  • ライフサイエンス / 麻酔科学

経歴

  • 新潟大学   医歯学総合病院 麻酔科   助教

    2024年5月 - 現在

  • 新潟大学   医歯学総合病院 麻酔科   特任助教

    2022年4月 - 2024年4月

  • 新潟大学   医歯学総合病院 麻酔科   助教

    2020年4月 - 2022年3月

 

論文

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

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

    Journal of Pharmacological Sciences   155 ( 2 )   63 - 73   2024年6月

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

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

    Journal of neurosurgical anesthesiology   2021年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    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. 国際誌

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

    Journal of neurosurgical anesthesiology   33 ( 3 )   230 - 238   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: 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年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    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年10月

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

    DOI: 10.1213/ane.0000000000005236

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

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

    Journal of Clinical Monitoring and Computing   35 ( 1 )   175 - 181   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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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    その他リンク: 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. 国際誌

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

    Journal of medical case reports   12 ( 1 )   204 - 204   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: 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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▶ 全件表示

共同研究・競争的資金等の研究

  • 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

    研究課題/領域番号:22K16610

    2022年4月 - 2024年3月

    制度名:科学研究費助成事業

    研究種目:若手研究

    提供機関:日本学術振興会

    出口 浩之

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

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  • 麻酔薬の脊髄前角細胞における作用機序の解明

    研究課題/領域番号:18K16441

    2018年4月 - 2021年3月

    制度名:科学研究費助成事業

    研究種目:若手研究

    提供機関:日本学術振興会

    出口 浩之

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    配分額:4030000円 ( 直接経費:3100000円 、 間接経費:930000円 )

    運動誘発電位は、術後の永続的な運動障害などを回避するために有用な術中神経生理学的モニタリングの一つである。しかし運動誘発電位は麻酔薬の影響を強く受けるためにその作用機序を解明することはモニタリングの解釈などの質を向上させるために重要である。比較的影響が少ないとされ、頻用されるプロポフォールも運動誘発電位振幅を要領依存性に抑制する。しかし、その詳細な作用機序は不明である。今回ヒトを対象としてプロポフォールの脊髄前角細胞の興奮性の指標である誘発筋電図振幅と運動誘発電位振幅を同時に評価することにより、プロポフォールの運動誘発電位振幅抑制効果の機序の一端を明らかにした。

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