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

File： Yanagimura(2024).pdf

DOI： 10.1016/j.neures.2023.11.003

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Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Frontiers Media SA  

Spinal cord injury (SCI) leads to the development of neuropathic pain. Although a multitude of pathological processes contribute to SCI-induced pain, excessive intracellular calcium accumulation and voltage-gated calcium-channel upregulation play critical roles in SCI-induced pain. However, the role of calcium-channel blockers in SCI-induced pain is unknown. Omega-conotoxin MVIIA (MVIIA) is a calcium-channel blocker that selectively inhibits N-type voltage-dependent calcium channels and demonstrates neuroprotective effects. Therefore, we investigated spinal analgesic actions and cellular mechanisms underlying the analgesic effects of MVIIA in SCI. We used SCI-induced pain model rats and conducted behavioral tests, immunohistochemical analyses, and electrophysiological experiments (in vitro whole-cell patch-clamp recording and in vivo extracellular recording). A behavior study suggested intrathecal MVIIA administration in the acute phase after SCI induced analgesia for mechanical allodynia. Immunohistochemical experiments and in vivo extracellular recordings suggested that MVIIA induces analgesia in SCI-induced pain by directly inhibiting neuronal activity in the superficial spinal dorsal horn. In vitro whole-cell patch-clamp recording showed that MVIIA inhibits presynaptic N-type voltage-dependent calcium channels expressed on primary afferent Aδ-and C-fiber terminals and suppresses the presynaptic glutamate release from substantia gelatinosa in the spinal dorsal horn. In conclusion, MVIIA administration in the acute phase after SCI may induce analgesia in SCI-induced pain by inhibiting N-type voltage-dependent calcium channels on Aδ-and C-fiber terminals in the spinal dorsal horn, resulting in decreased neuronal excitability enhanced by SCI-induced pain.

File： Ohashi(Frontiers,2024).pdf

DOI： 10.3389/fnins.2024.1366829

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Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)  

File： 安部先生（誌上抄読会）.pdf

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File： Kurabe(iScience,2022).pdf

DOI： 10.1016/j.isci.2022.105555

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Language：Japanese   Publisher：(一社)日本集中治療医学会  

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

File： Matsuda(J Pain,2022).pdf

DOI： 10.1016/j.jpain.2022.06.001

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Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Ovid Technologies (Wolters Kluwer Health)  

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.

File： Mitsuma(J Neurosurg Anesth,2021).pdf

DOI： 10.1097/ANA.0000000000000784

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File： Ohashi(Pain,2022).pdf

DOI： 10.1097/j.pain.0000000000002523

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File： Kita(Medicine,2022).pdf

DOI： 10.1097/md.0000000000029709

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File： Ohashi(Neurocience,2022).pdf

DOI： 10.1016/j.neuroscience.2022.03.023

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Public Library of Science (PLoS)  

Yokukansan (YKS) is a traditional Japanese herbal (Kampo) medicine prescribed for anxiety. In this randomized controlled trial, we compared the subjective assessment of anxiety using questionnaires and its objective assessment using salivary alpha-amylase concentrations in YKS and control (CNT) groups of women undergoing breast surgery. The trial was registered at the University Hospital Medical Information Network Clinical Trials Registry (registration number: UMIN000028998), and the investigators were blinded to drug administration. One hundred patients who underwent breast cancer surgery were allocated to either the YKS or the CNT group. Finally, 35 and 42 patients in the YKS and CNT groups were analyzed, respectively. The YKS group received two 2.5 g doses of the medication before sleeping on the night before surgery and 2 h before inducing anesthesia, while the CNT group did not receive medication preoperatively. Patients answered two questionnaires, the Hospital Anxiety and Depression Scale and the State-Trait Anxiety Inventory, pre-and postoperatively as subjective anxiety assessments. As an objective anxiety indicator, salivary alpha-amylase levels were measured the day before, directly before, and the day after surgery (T3). In the YKS group, salivary alpha-amylase scores directly before operation were significantly lower than those on the day before surgery and at one day postoperatively (F [2,150] = 3.76, p = 0.03). Moreover, the Hospital Anxiety and Depression Scale-Anxiety and State-Trait Anxiety Inventory-Trait scores were significantly more improved postoperatively in the YKS group than in the CNT group (difference in Hospital Anxiety and Depression Scale-Anxiety: YKS, mean -2.77, 95% confidence interval [-1.48 –-4.06], p &lt;0.001, and CNT, -1.43 [-0.25–-2.61], p = 0.011; and difference in State-Trait Anxiety Inventory: YKS group, -4.23 [-6.95–-1.51], p = 0.0004; and CNT group, 0.12 [-2.36–2.60], p = 0.92). No side effects were associated with YKS. YKS may reduce perioperative anxiety in patients undergoing surface surgery.

File： Tanaka M(PlosOne,2021).pdf

DOI： 10.1371/journal.pone.0260524

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BACKGROUND: An epidurally administered local anesthetic acts primarily on the epidural nerve roots and can act directly on the spinal cord through the dural sleeve. We hypothesized that epidurally administered ropivacaine would reduce the amplitude of transcranial electrical motor-evoked potentials by blocking nerve conduction in the spinal cord. Therefore, we conducted a double-blind, randomized, controlled trial. METHODS: Thirty adult patients who underwent lung surgery were randomly allocated to 1 of 3 groups, based on the ropivacaine concentration: the 0.2% group, the 0.375% group, and the 0.75% group. The attending anesthesiologists, neurophysiologists, and patients were blinded to the allocation. The epidural catheter was inserted at the T5-6 or T6-7 interspace by a paramedian approach, using the loss of resistance technique with normal saline. General anesthesia was induced and maintained using propofol and remifentanil. Transcranial electrical motor-evoked potentials were elicited by a train of 5 pulses with an interstimulus interval of 2 milliseconds by using a constant-voltage stimulator and were recorded from the tibialis anterior muscle. Somatosensory-evoked potentials (SSEPs) were evoked by electrical tibial nerve stimulation at the popliteal fossa. After measuring the baseline values of these evoked potentials, 10 mL of epidural ropivacaine was administered at the 0.2%, 0.375%, or 0.75% concentration. The baseline amplitudes and latencies recorded before administering ropivacaine were defined as 100%. Our primary end point was the relative amplitude of the motor-evoked potentials at 60 minutes after the epidural administration of ropivacaine. We analyzed the amplitudes and latencies of these evoked potentials by using the Kruskal-Wallis test and used the Dunn multiple comparison test as the post hoc test for statistical analysis. RESULTS: The data are expressed as the median (interquartile range). Sixty minutes after epidurally administering ropivacaine, the motor-evoked potential amplitude was lower in the 0.75% group (7% [3%-18%], between-group difference P < .001) and in the 0.375% group (52% [43%-59%]) compared to that in the 0.2% group (96% [89%-105%]). The latency of SSEP was longer in the 0.75% group compared to that in the 0.2% group, but the amplitude was unaffected. CONCLUSIONS: Epidurally administered high-dose ropivacaine lowered the amplitude of motor-evoked potentials and prolonged the onset latencies of motor-evoked potentials and SSEPs compared to those in the low-dose group. High-dose ropivacaine can act on the motor pathway through the dura mater.

File： Furutani(A&A,2021).pdf

DOI： 10.1213/ane.0000000000005236

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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.

File： Furutani (2019).pdf

DOI： 10.1097/ANA.0000000000000653

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Authorship：Last author   Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：克誠堂出版(株)  

File： 成人ムコ多糖症（三ッ間,2021,麻酔）.pdf

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01397&link_issn=&doc_id=20210601120006&doc_link_id=%2Fad3msuie%2F2021%2F007006%2F007%2F0602b0605%26dl%3D3&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fad3msuie%2F2021%2F007006%2F007%2F0602b0605%26dl%3D3&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_4.gif

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

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.

File： Deguchi2021_Article_PropofolReducesTheAmplitudeOfT.pdf

DOI： 10.1007/s00540-021-02927-7

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Other Link： http://link.springer.com/article/10.1007/s00540-021-02927-7/fulltext.html

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File： Deguchi(J Clin MonitComput.2021).pdf

DOI： 10.1007/s10877-020-00464-4

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File： 相馬先生（JA Clinical Reports).pdf

DOI： 10.1186/s40981-020-00349-0

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Other Link： http://link.springer.com/article/10.1186/s40981-020-00349-0/fulltext.html

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File： Quadratus lumborum block(Watanabe,2020,JA CR).pdf

DOI： 10.1186/s40981-020-00342-7

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Other Link： http://link.springer.com/article/10.1186/s40981-020-00342-7/fulltext.html

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Ovid Technologies (Wolters Kluwer Health)  

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.

File： Furutani(2020,Medicine).pdf

DOI： 10.1097/md.0000000000022545

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Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)  

File： 番場景子・学位論文.pdf

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Authorship：Last author   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

File： Imai(JA,2020).pdf

DOI： 10.1007/s00540-020-02807-6

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Other Link： http://link.springer.com/article/10.1007/s00540-020-02807-6/fulltext.html

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Ovid Technologies (Wolters Kluwer Health)  

This case report describes a neonate with tracheal aplasia first diagnosed after birth due to the presentation of respiratory distress, absence of crying, and unsuccessful tracheal intubation. The most common finding with tracheal aplasia is polyhydramnios. However, diagnosis remains challenging in the prenatal period. In this case, maternal obesity and gestational diabetes made diagnosis more difficult. The only lifesaving treatment available is ventilation through esophageal intubation or tracheostomy. However, in some cases, tracheostomy is not an option.

File： Congenital Tracheal(Yamamoto,A&A,2020).pdf

DOI： 10.1213/xaa.0000000000001200

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File： 9年間肘痛のみの症状が持続した尺骨神経炎の1例.pdf

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Authorship：Last author   Language：Japanese   Publishing type：Research paper (scientific journal)  

File： 難治性の直腸がん術後の肛門痛に漢方治療が奏効した一症例.pdf

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Language：English   Publishing type：Doctoral thesis  

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.

File： Onishi(JP,2019).pdf

DOI： 10.1113/JP277615

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Language：English   Publishing type：Doctoral thesis   Publisher：Elsevier BV  

File： Seino(2019,J of Cardiothoracic and Vascular Anesthesia).pdf

DOI： 10.1053/j.jvca.2018.10.023

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：真興交易(株)医書出版部  

File： 清水（臨床麻酔,2019）.pdf

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Language：English   Publishing type：Doctoral thesis  

BACKGROUND: The neurosteroid dehydroepiandrosterone sulphate (DHEAS) activates the sigma-1 receptor, inhibits gamma-aminobutyric acid A (GABAA) and glycine receptors, and induces hyperalgesic effects. Although its effects have been studied in various tissues of the nervous system, its synaptic mechanisms in nociceptive pathways remain to be elucidated. METHODS: The threshold of mechanical hypersensitivity and spontaneous pain behaviour was assessed using the von Frey test in adult male Wistar rats after intrathecal administration of DHEAS. We also investigated the effects of DHEAS on synaptic transmission in the spinal dorsal horn using slice patch-clamp electrophysiology. RESULTS: Intrathecally administered DHEAS elicited dose-dependent mechanical hyperalgesia and spontaneous pain behaviours (withdrawal threshold: saline; 51.0 [20.1] g, 3 μg DHEAS; 14.0 [7.8] g, P<0.01, 10 μg DHEAS; 6.9 [5.2] g, 15 min after administration, P<0.001). DHEAS at 100 μM increased the frequency of miniature postsynaptic currents in the rat dorsal spinal horn; this increase was extracellular Ca2+-dependent but not sigma-1 and N-methyl-d-aspartate receptor-dependent. DHEAS suppressed the frequency of miniature inhibitory postsynaptic currents in a GABAA receptor- and sigma-1 receptor-dependent manner. CONCLUSIONS: These results suggest that DHEAS participates in the pathophysiology of nociceptive synaptic transmission in the spinal cord by potentiation of glutamate release and inhibition of the GABAA receptor.

File： Yamamoto G(BJA,2019).pdf

DOI： 10.1016/j.bja.2019.03.026

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Noradrenaline (NA) modulates the spinal motor networks for locomotion and facilitates neuroplasticity, possibly assisting neuronal network activation and neuroplasticity in the recovery phase of spinal cord injuries. However, neither the effects nor the mechanisms of NA on synaptic transmission and neuronal excitability in spinal ventral horn (VH) neurons are well characterized, especially in rats aged 7 postnatal days or older. To gain insight into NA regulation of VH neuronal activity, we used a whole-cell patch-clamp approach in late neonatal rats (postnatal day 7-15). In voltage-clamp recordings at -70 mV, NA increased the frequency and amplitude of excitatory postsynaptic currents via the activation of somatic α1- and β-adrenoceptors of presynaptic neurons. Moreover, NA induced an inward current through the activation of postsynapticα1- and β-adrenoceptors. At a holding potential of 0 mV, NA also increased frequency and amplitude of both GABAergic and glycinergic inhibitory postsynaptic currents via the activation of somatic adrenoceptors in presynaptic neurons. In current-clamp recordings, NA depolarized resting membrane potentials and increased the firing frequency of action potentials in VH neurons, indicating that it enhances the excitability of these neurons. Our findings provide new insights that establish NA-based pharmacological therapy as an effective method to activate neuronal networks of the spinal VH in the recovery phase of spinal cord injuries.

File： Neuroscience 論文.pdf

DOI： 10.1016/j.neuroscience.2019.03.026

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Lamina X is localized in the spinal cord within the region surrounding the central canal and receives descending projections from the supraspinal nuclei. Norepinephrine (NE) is a neurotransmitter in descending pathways emanating from the brain stem; NE-containing fibers terminate in the spinal dorsal cord, particularly in the substantia gelatinosa (SG). NE enhances inhibitory synaptic transmission in SG neurons by activating presynaptic α1-receptors and hyperpolarizes the membranes of SG neurons by acting on α2-receptors; NE may thus act directly on SG neurons of the dorsal spinal cord and inhibit nociceptive transmission at the spinal level. NE-containing fibers also reportedly terminate in lamina X, suggesting that NE also modulates synaptic transmission in lamina X. However, the cellular mechanisms underlying such action have not been investigated. We hypothesized that NE might directly act on lamina X and enhance inhibitory synaptic transmission therein. Using rat spinal cord slices and in vitro whole-cell patch-clamps, we found that the bath-application of NE to lamina X does not affect the excitatory interneurons but enhances GABAergic and glycinergic miniature inhibitory postsynaptic currents (mIPSCs) and induces an outward current. NE-induced enhancement of mIPSCs was blocked by α1A-receptor antagonists, and NE-induced outward current was blocked by α2-receptor antagonists. NE did not affect GABA- or glycine- induced outward currents. These findings are similar to those obtained from SG neurons: NE may act at presynaptic terminals of GABAergic and glycinergic interneurons on lamina X to facilitate inhibitory-transmitter release through α1A-receptor activation and directly induce inhibitory interneuron membrane hyperpolarization through α2-receptors activation.

File： Ohashi(Neurocience,2019).pdf

DOI： 10.1016/j.neuroscience.2019.04.004

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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.

File： Neural block therapy for radiation enteritis(Tanaka,JACR,2019).pdf

DOI： 10.1186/s40981-019-0239-9

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Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Termedia Sp. z.o.o.  

File： Yamamoto(Anaesthesiology Intensive Therapy,2019.pdf

DOI： 10.5114/ait.2019.89225

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

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.

File： Watanabe T(JA,2018).pdf

DOI： 10.1007/s00540-018-2550-4

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OBJECTIVES: Determination of the appropriate tracheal tube size using formulas based on age or height often is inaccurate in pediatric patients with congenital heart disease (CHD), particularly in those with high pulmonary arterial pressure (PAP). Here, the authors compared tracheal diameters between pediatric patients with CHD with high PAP and low PAP. DESIGN: Retrospective clinical study. SETTING: Hospital. PARTICIPANTS: Pediatric patients, from birth to 6 months of age, requiring general anesthesia and tracheal intubation who underwent computed tomography were included. Patients with mean pulmonary artery pressure >25 mmHg were allocated to the high PAP group, and the remaining patients were allocated to the low PAP group. The primary outcome was the tracheal diameter at the cricoid cartilage level, and the secondary goal was to observe whether the size of the tracheal tube was appropriate compared with that obtained using predictable formulas based on age or height. MEASUREMENTS AND MAIN RESULTS: The mean tracheal diameter was significantly larger in the high PAP group than in the low PAP group (p < 0.01). Pediatric patients with high PAP required a larger tracheal tube size than predicted by formulas based on age or height (p = 0.04 for age and height). CONCLUSIONS: Pediatric patients with high PAP had larger tracheal diameters than those with low PAP and required larger tracheal tubes compared with the size predicted using formulas based on age or height.

File： Ohashi N (J Car and Vasc Anes,2018).pdf

DOI： 10.1053/j.jvca.2017.12.004

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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.

File： Furutani(JM case reports,2018).pdf

DOI： 10.1186/s13256-018-1741-9

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We used a multimodal approach to evaluate the effects of edaravone in a rat model of spinal cord injury (SCI). SCI was induced by extradural compression of thoracic spinal cord. In experiment 1, 30 min prior to compression, rats received a 3 mg/kg intravenous bolus of edaravone followed by a maintenance infusion of 1 (low-dose), 3 (moderate-dose), or 10 (high-dose) mg/kg/h edaravone. Although both moderate- and high-dose edaravone regimens promoted recovery of spinal motor-evoked potentials (MEPs) at 2 h post-SCI, the effect of the moderate dose was more pronounced. In experiment 2, moderate-dose edaravone was administered 30 min prior to compression, at the start of compression, or 10 min after decompression. Although both preemptive and coincident administration resulted in significantly improved spinal MEPs at 2 h post-SCI, the effect of preemptive administration was more pronounced. A moderate dose of edaravone resulted in significant attenuation of lipid peroxidation, as evidenced by lower concentrations of the free radical malonyldialdehyde in the spinal cord 3 h post-SCI. Malonyldialdehyde levels in the high-dose edaravone group were not reduced. Both moderate- and high-dose edaravone resulted in significant functional improvements, evidenced by better Basso-Beattie-Bresnahan (BBB) scores and better performance on an inclined plane during an 8 week period post-SCI. Both moderate- and high-dose edaravone significantly attenuated neuronal loss in the spinal cord at 8 weeks post-SCI, as evidenced by quantitative immunohistochemical analysis of NeuN-positive cells. In conclusion, early administration of a moderate dose of edaravone minimized the negative consequences of SCI and facilitated functional recovery.

File： Ishi (Brain Res, 2018).pdf

DOI： 10.1016/j.brainres.2017.12.035

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Background: Sorafenib (SOR) is a molecular medicine that prolongs the survival of patients with hepatocellular carcinoma (HCC). Therefore, the management of side effects is essential for the longer period of continuous medication. Among the various side effects, hand-foot syndrome (HFS) is the most common, occurring in 30%-50% of patients, and often results in discontinuation of the SOR medication. However, its mechanism has not been clarified, and no effective prevention method has been reported for the symptoms. Therefore, this study aimed to analyze its mechanism and to develop an effective prevention regimen for the symptoms. Materials and methods: To assess the mechanism of SOR-induced HFS, the peripheral blood flow in the hand and foot was carefully monitored by Doppler ultrasound, thermography, and laser speckle flowgraphy in the cases treated with SOR and its contribution was assessed. Then, the effect of dried-bonito broth (DBB), which was reported to improve peripheral blood flow, on the prevention of the symptom was examined by monitoring its occurrence and the peripheral blood flow. Results: A total of 25 patients were enrolled in this study. In all, eight patients developed HFS, and all cases showed a significant decrease in the peripheral blood flow. DBB contributed to an increase in the flow (p = 0.009) and significantly decreased occurrence of HFS (p = 0.005) than control. Multivariable analysis showed that the ingestion of DBB is a significant independent contributor to HFS-free survival period (p = 0.035). Conclusion: The mechanism of SOR-induced HFS involves a decrease in the peripheral blood flow, and the ingestion of DBB effectively prevents the development of the syndrome by maintaining the flow.

File： Kamimura K(Cancer management and research,2018).pdf

DOI： 10.2147/CMAR.S159370

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File： 大橋(Cardiovasular Anesthesia2018).pdf

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File： 原（麻酔, 2017）.pdf

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File： Watanabe T(bjcp,2017).pdf

DOI： 10.1111/bcp.13334

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File： Furutani (Medicine,2018).pdf

DOI： 10.1097/MD.0000000000007983

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File： Intraoperative_Detection_of_Persistent_Endolea.pdf

DOI： 10.1213/ANE.0000000000002207

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File： Terukina(JA, 2017).pdf

DOI： 10.1007/s00540-017-2325-3

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File： 渡部(Eur J Anaesthesiology,2017).pdf

DOI： 10.1097/EJA.0000000000000572

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File： Petrenko(Anesthesiology,2017).pdf

DOI： 10.1097/ALN.0000000000001445

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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.

File： Watanabe(JA Clinical aReport, 2017).pdf

DOI： 10.1186/s40981-017-0110-9

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File： 清水（臨床放射線,2017）.pdf

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File： Yoshida(2016,BJA).pdf

DOI： 10.1093/bja/aew339

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File： Pregabalin(2016).pdf

DOI： 10.1016/j.brainres.2016.08.018

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File： Ohashi M(Neuroscience,2016).pdf

DOI： 10.1016/j.neuroscience.2016.06.033

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File： Yoshida(2016,J Anes).pdf

DOI： 10.1007/s00540-016-2170-9

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File： 大橋（Surg Tuday,2016).pdf

DOI： 10.1007/s00595-015-1280-6

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File： Kurabe(2016,SciRep).pdf

DOI： 10.1038/srep26253

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japanese Journal of Cancer and Chemotherapy Publishers Inc.  

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File： Watanabe T(JA,2016) .pdf

DOI： 10.1007/s00540-015-2113-x

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File： Yoshida(Anaesthesia,2016).pdf

DOI： 10.1111/anae.13336

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File： Pain Research(2016).pdf

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File： Ohashi M(JP,2016).pdf

DOI： 10.1113/JP271449

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Background: Maternal uniparental disomy 14 (UPD(14)mat) is an imprinting disorder. It is a rare disease, but there is the possibility that more undiagnosed patients might exist because the clinical features of UPD(14)mat resemble those of the Prader-Willi syndrome or other congenital diseases. We performed anesthetic management for an 8-year-old girl with UPD(14)mat. Case presentations: She was admitted to undergo correction surgery due to symptomatic scoliosis. Preoperative examination revealed that she had a restricted mouth opening and retrognathia, as well as some typical characteristics of UPD(14)mat, such as small hands, growth retardation, and precocious puberty. We induced general anesthesia using sevoflurane without any problems. However, the tracheal intubation was difficult because of the restricted mouth opening. We used the McGRATHR MAC videolaryngoscope to overcome this problem. Conclusions: We speculate that the craniofacial deformity in case of UPD(14)mat patients may lead to difficulty in tracheal intubation.

File： Furutani(JA Cli Rep,2016).pdf

DOI： 10.1186/s40981-016-0051-8

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We report a case of successful pulsed radiofrequency stimulation of the pudendal nerve for pudendal neuralgia. A 70-year-old woman suffered from perineal pain for 3 months. The pain was predominantly experienced only in the sitting position. She experienced tenderness by palpation of the bilateral ischial spine. After diagnosis with pudendal neuralgia according to Nantes Criteria, she was treated with the pulsed radio frequency of the pudendal nerve, and the pain was well controlled.

File： 清水（ペイン学会誌,2016).pdf

DOI： 10.11321/jjspc.16-0013

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File： Hiruma(Can J Anes,2015.pdf

DOI： 10.1007/s12630-015-0400-5

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File： Petrenko(Eur J Pharm,2015).pdf

DOI： 10.1016/j.ejphar.2015.08.048

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File： Ohashi(Sci Rep,2015).pdf

DOI： 10.1038/srep13458

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File： Ishii (EJA,2015).pdf

DOI： 10.1097/EJA.0000000000000258

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File： Watanabe (Sci Rep,2015).pdf

DOI： 10.1038/srep11191

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File： Watanabe(Can J Anes,2015).pdf

DOI： 10.1007/s12630-015-0331-1

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File： Shimizu(JA Cli Report,2015).pdf

DOI： 10.1186/s40981-015-0023-4

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Background: Acute postoperative pain is an integral risk factor in the development of chronic pain after breast cancer surgery (BCS). Pectoral nerve block (PECSB) has been recently reported as an analgesic method for BCS. Here, we retrospectively compared intraoperative opioid requirement, postoperative pain after BCS, and incidence of postoperative nausea and vomiting (PONV) in patients who underwent BCS under total intravenous anesthesia (TIVA) with or without PECSB. Findings: We reviewed anesthesia charts and medical records of 146 patients who underwent BCS at Niigata University Medical and Dental Hospital from January 2013 to March 2014; 36 patients were included in the TIVA group, and 35 patients were included in the TIVA + PECSB group. Intraoperative remifentanil requirements were significantly lower in the TIVA + PECSB group than in the TIVA group, and the cumulative distribution of remifentanil was reduced in patients who received PECSB (TIVA: 10.9 ± 2.9 μg/kg/h; TIVA + PECSB: 7.3 ± 3.3 μg/kg/h; p < 0.001). Postoperative pain scores during the 48 h after surgery were significantly lower in the TIVA + PECSB group than in the TIVA group (TIVA: 2 [1-5]; TIVA + PECSB: 1 [0-5]; p = 0.03). However, administration of fentanyl during operation, percentage of patients requiring supplemental analgesics, and incidence of PONV were not significantly different between groups. Conclusions: PECSB significantly reduced intraoperative remifentanil usage and postoperative pain. However, the requirement for postoperative supplemental analgesics and the incidence of PONV did not differ. These data suggested that PECSB may be useful for perioperative pain management in patients undergoing BCS.

File： Morioka (JA CR, 2015).pdf

DOI： 10.1186/s40981-015-0018-1

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File： Honda(JA,2014).pdf

DOI： 10.1007/s00540-014-1829-3

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File： Petrenko(A&A,2014).pdf

DOI： 10.1213/ANE.0000000000000391

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File： Petrenko(Behav Rrain Res,2014).pdf

DOI： 10.1016/j.bbr.2014.05.063

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File： Watanabe(JA,2014).pdf

DOI： 10.1007/s00540-013-1707-4

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DOI： 10.1111/anae.12531

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File： Petrenko(A&A,2014,Hypnotic).pdf

DOI： 10.1213/ANE.0000000000000025

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File： Ohash(J Med Case Rep,2014).pdf

DOI： 10.1186/1752-1947-8-32

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File： Petrenko(Eur J Pharmacol,2014).pdf

DOI： 10.1016/j.ejphar.2013.11.039

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File： 過酸化水素(Ohashi M,2014).pdf

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File： 大橋（脊髄機能診断,2014）.pdf

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File： ステロイド(Yamamoto G,2014).pdf

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File： リドカイン(2014).pdf

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File： 江村美紗（麻酔,2014）.pdf

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File： 大橋（2013）.pdf

DOI： 10.11321/jjspc.12-0045

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DOI： 10.11321/jjspc.12-0036

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File： Ishii(Mol Pian, 2013).pdf

DOI： 10.1186/1744-8069-9-11

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File： Petrenko(Eur J Pharmacol,2013).pdf

DOI： 10.1016/j.ejphar.2012.10.034

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Language：Japanese   Publisher：JAPANESE ASSOCIATION FOR STUDY OF PAIN  

Tranexamic acid (TXA) is an antifibrinolytic agent widely used to reduce blood loss during surgery. However, a serious adverse effect of TXA is seizure due to inhibition of γ–aminobutyric acid (GABA) and glycine receptors in cortical neurons. These receptors are also present in the spinal cord, and antagonism of these receptors in spinal dorsal horn neurons produces painrelated phenomena, such as allodynia and hyperalgesia. Moreover, some patients who are injected intrathecally with TXA develop severe back pain. However, no previous studies have investigated whether TXA modulates the GABA and glycine receptors in dorsal horn neurons. We hypothesized that TXA inhibits both GABA and glycine receptors in dorsal horn neurons,resulting in producing pain. Here, we investigated the effects of TXA by using behavioral measures in rats and found that TXA produces behaviors indicative of spontaneous pain and allodynia. We then performed wholecell patch–clamp experiments that showed that TXA inhibits GABAA and glycine receptors in spinal dorsal horn neurons. Finally, we also showed that TXA facilitates activation of the extracellular signal–regulated kinase in the spinal cord. These results indicated that TXA produces pain by inhibiting GABAA and glycine receptors directly located on postsynaptic sites of the recorded SG neurons. In addition, TXA enhances the excitability of excitatory interneurons via blockade of GABAergic and glycinergic postsynaptic inhibition, which facilitates excitatory transmission to the SG neurons indirectly.

DOI： 10.11154/pain.31.9

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File： Petrenko(Anesthesiology,2012).pdf

DOI： 10.1097/ALN.0b013e318272d898

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File： Petrenko(A&A,2012).pdf

DOI： 10.1213/ANE.0b013e318263ca5c

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File： Honda(A & A,2012).pdf

DOI： 10.1213/ANE.0b013e318259393d

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File： Kohno(Mol Pain,2012).pdf

DOI： 10.1186/1744-8069-8-45

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A 26-year-old woman with Ehlers-Danlos syndrome (EDS) underwent posterior spinal fusion with instrumentation for scoliosis. General anesthesia was maintained using propofol and remifentanil. The procedure was performed examining the motor evoked potential (MEP) and somatosensory evoked potential (SSEP) of the lower extremities with the patient placed in the prone position. The procedure was completed successfully without major cardiovascular or respiratory complications. The duration of anesthesia was 821 min. When drapes were removed, we noticed that the right shoulder was in a hyperabduction position. After emergence from anesthesia, it was observed that the right upper extremity was paralyzed. Thereafter, brachial plexus injury, which may have been due to intraoperative malpositioning, was diagnosed. Brachial plexus injury is the most common among the nerve injuries resulting from intraoperative malpositioning. Patients with EDS are thought to be at high risk for the complications and it has also been reported that patients with joint hypermobility, such as that in EDS or Marfan syndrome, are highly susceptible to nerve injury. Intraoperative monitoring of the MEP and SSEP in the upper extremities should be considered for early detection and prevention of brachial plexus injury in patients with EDS who are thought to be at high risk.

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File： Yamamoto(Anesthesiology,2012).pdf

DOI： 10.1097/ALN.0b013e31825037a1

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File： Petrenko(Anesthesiology,2012).pdf

DOI： 10.1097/ALN.0b013e318245bfce

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File： Ishii(Anesthesiology,2012).pdf

DOI： 10.1097/ALN.0b013e31823cfaad

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File： Watanabe(Can J Anes,2012).pdf

DOI： 10.1007/s12630-011-9613-4

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File： 日本臨床麻酔学会誌.32.大西2012.pdf

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File： Imai(JA, 2011).pdf

DOI： 10.1007/s00540-011-1231-3

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File： Kurokawa(A&A,2011).pdf

DOI： 10.1213/ANE.0b013e31821e9765

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File： Honda(Neuroscience Letters,2011).pdf

DOI： 10.1016/j.neulet.2011.03.003

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We report anesthetic management of a 6-month-old boy with Menkes disease who underwent three surgeries for vesicoureteral reflux, rupture of the bladder diverticulum, inguinal hernia, and gastroesophageal reflux. Menkes disease is a rare sex-linked disorder of copper absorption and metabolism. Anesthetic management of such patients is rather challenging because of high incidence of seizures, gastroesophageal reflux with the risk of aspiration, hypothermia, airway and vascular complications. In our patient general anesthesia was uneventfully maintained by sevoflurane combined with intravenous remifentanil and fentanyl. We experienced no major complications except some difficulties with intravenous and arterial cannulation. It was especially difficult to establish intravenous and invasive blood pressure lines because of tortuous blood vessels in this patient. We conclude that in patients with Menkes disease scheduled for surgery intravenous access should be established before the induction of general anesthesia. The necessity of invasive blood pressure monitoring should be also carefully considered beforehand.

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File： Kurokawa(JA, 2010).pdf

DOI： 10.1007/s00540-010-0896-3

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File： Watanabe(J of clinical anesthesia,2010).pdf

DOI： 10.1016/j.jclinane.2009.09.002

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File： Georgiev(Mol Pain,2010).pdf

DOI： 10.1186/1744-8069-6-25

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File： Seo(Neuroscience Letters, 2010).pdf

DOI： 10.1016/j.neulet.2010.01.031

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File： Petrenko(A&A,2010).pdf

DOI： 10.1213/ANE.0b013e3181c76e73

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DOI： 10.1177/039139881003300202

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File： Furutani(Anesthesiology,2010).pdf

DOI： 10.1097/01.anes.0000365964.97138.9a

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File： Georgiev(Eur J Pain,2010).pdf

DOI： 10.1016/j.ejpain.2009.01.008

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A 7-year-old boy with congenital myotonic dystrophy (MD) and developmental retardation underwent an emergency surgery for strangulation ileus. General anesthesia was maintained using sevoflurane and fentanyl. While intraoperative arterial blood pressure, pulse and rectal temperature remained stable, the arterial blood oxygenation gradually deteriorated during the procedure. We suspected the existence of atelectasis or some other obstructive lung lesion to be the underlying cause, and performed bronchoscopic examination which revealed a collapse of the left main bronchus. Therefore, postoperative mechanical ventilation was continued for several hours in the ICU. According to the postoperative computed tomography, the left main bronchus was sandwiched between the aortic arch and thoracic vertebra. It has been reported that MD patients have a risk of perioperative pulmonary complications, particularly in those who have severe muscular disability undergoing upper abdominal surgery. These risk factors combined with bronchial stenosis could have caused intraoperative hypoxia in our patient. We conclude that when a severe MD patient is scheduled for an upper abdominal surgery, mechanical ventilation should be considered until spontaneous recovery from muscle relaxants occurs. Also, since MD has been related to malignant hyperthermia, total intravenous anesthesia, possibly combined with regional blockade, is a preferable method of anesthesia for such patients.

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File： N2O(脊髄機能診断,2009）.pdf

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File： Bupivacaine(脊髄機能診断,2009）.pdf

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA  

A 58-year-old woman presented with severe hypoxemia. Chest radiography showed patchy infiltrates in both lungs. A diagnosis of pulmonary alveolar proteinosis (PAP) was made. The patient needed whole-lung lavage (WLL) , and the support of extracorporeal membrane oxygenation (ECMO) was required during this procedure because of severe hypoxemia (PaO₂ 38mmHg, breathing ambient air) . We performed the ECMO-assisted left WLL without fatal hypoxemia. It is suggested that ECMO support enables PAP patients with severe hypoxemia to maintain good oxygenation during aggressive WLL and results in early patient recovery.

DOI： 10.2199/jjsca.29.829

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DOI： 10.1017/S0265021508004626

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DOI： 10.1111/j.1460-9568.2008.06260.x

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File： Wu(Neuroreport,2008).pdf

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DOI： 10.1016/j.pain.2007.03.026

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File： シンポジウム（麻酔メカニズム2007）.pdf

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File： Petrenko(Anesthesiology,2007.pdf

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File： Ogawa M(Neuroscience Research,2007).pdf

DOI： 10.1016/j.neures.2006.11.011

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DOI： 10.2199/jjsca.27.332

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DOI： 10.2199/jjsca.27.684

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File： シンポジウム（麻酔メカニズム2007）.pdf

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DOI： 10.1016/j.neuropharm.2005.11.019

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File： Kohno(Anesthesiology,2006).pdf

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File： Georgiev(A&A,2006).pdf

DOI： 10.1213/01.ane.0000184829.25310

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File： Opioid(脊髄機能診断,2006).pdf

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DOI： 10.1016/j.ics.2005.07.042

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DOI： 10.1016/j.neures.2005.05.002

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File： Yamakura(A&A2005).pdf

DOI： 10.1213/01.ANE.0000152324.30272.49

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File： Wakai(Anesthesiology,2005).pdf

DOI： 10.1097/00000542-200502000-00021

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DOI： 10.11321/jjspc1994.12.10

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File： Petrenko(A&A,2004).pdf

DOI： 10.1213/01.ANE.0000131729

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File： Baba & Ji(MCN,2003).pdf

DOI： 10.1016/S1044-7431(03)00236-7

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File： Petrenko(A&A,2003).pdf

DOI： 10.1213/01.ANE.0000081061.12235.55

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File： Tobita(2003).pdf

DOI： 10.1097/01.BRS.0000083595.10862.98

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Language：Japanese   Publisher：日本臨床麻酔学会  

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File： Tobita(A&A,2003).pdf

DOI： 10.1216/01.ANE.0000068980.4025.4C

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File： Chaoran Wu,.pdf

DOI： 10.1161/01.STR.0000077255.15597.69

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DOI： 10.1016/S0168-0102(03)00061-0

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File： JP(2003).pdf

DOI： 10.1113/jphysiol.2002.036186

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File： Isoflurane(脊髄機能診断,2003）.pdf

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File： PGE2(脊髄機能診断,2003）.pdf

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File： NA(岡本、臨床麻酔）.pdf

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File： Fiber(脊髄機能診断,2003）.pdf

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File： Moore(Neuropharmacology).pdf

DOI： 10.1016/S0028-3908(02)00226-5

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File： Zhan(Anesthesiology,2002),.pdf

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File： Ishii(A&A,2002).pdf

DOI： 10.1213/01.ANE.000019029.7747.C2

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File： Moore (JNS).pdf

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DOI： 10.1097/00001756-200203040-00021

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DOI： 10.1016/S0304-3940(01)02368-0

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File： Chen(Neuron).pdf

DOI： 10.1016/S0896-6273(01)00341-5

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File： Okamoto(JP,2001).pdf

DOI： 10.1111/j.1469-7793.2001.0241g.x

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File： Baba(PGE2,JNS,2001).pdf

DOI： 10.1523/JNEUROSCI.21-05-01750.2001

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File： Aida(Anesthesiology,2000).pdf

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File： Midazolam(2000).pdf

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File： Kohno(Anesthesiology,2000).pdf

DOI： 10.1097/00000542-200602000-00020

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File： Ji RR,Nature Neurosci(1999).pdf

DOI： 10.1038/16040

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File： Ji RR,Nature Neurosci(1999).pdf

DOI： 10.1038/16040

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File： Baba,Muscarinic(JP,1998).pdf

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DOI： 10.1007/BF02480068

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File： Pain Research(1997)圧縮.pdf

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File： Denda(BJA,1996).pdf

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Language：Japanese   Publisher：JAPANESE ASSOCIATION FOR STUDY OF PAIN  

DOI： 10.11154/pain.10.51

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DOI： 10.1007/BF02514635

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File： jphysiol00345-0089.pdf

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Other Link： http://search.jamas.or.jp/link/ui/2012211811

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DOI： 10.1097/WNR.0b013e3282f50c90

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DOI： 10.1016/j.pain.2007.03.026

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DOI： 10.1097/01.anes.0000286985.80301.5e

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Authorship：Corresponding author   Language：English   Publisher：Niigata University  

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