Faculty Profiles - BABA Hiroshsi

Papers - BABA Hiroshsi

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Unintentional epidural placement of a thoracic paravertebral catheter inserted using an ultrasound-guided technique: a case report Reviewed

Takayuki Yoshida, Hiroki Shimizu, Kenta Furutani, Hiroshi Baba

JOURNAL OF ANESTHESIA 30 ( 4 ) 727 - 730 2016.8

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

This is the first case report describing the epidural misplacement of an infusion catheter, which was intended to be located in the thoracic paravertebral space using an ultrasound-guided technique. The patient was a 57-year-old female undergoing a laparoscopy-assisted left partial nephrectomy. Before surgery, a Tuohy needle was inserted into the paravertebral space at the left ninth intercostal space using an in-plane transverse ultrasound-guided approach in the lateral-to-medial direction. A catheter was then threaded into the paravertebral space through the needle. Subsequently, the catheter position was secured, although ultrasound-guided confirmation of air injected through the catheter into the paravertebral space was not obtained. Twenty milliliters of 0.5 % levobupivacaine was administered through the catheter at both the initiation and conclusion of surgery. A neurologic examination following surgery revealed paraplegia, along with sensory deficits in the bilateral T3-S5 dermatome. The motor dysfunction in the lower extremities lasted 7 h, and the sensory block lasted 13.5 h. Postoperative radiologic confirmation of the catheter position concomitant with the spread of radiopaque dye revealed that the tip of the catheter was lying in the epidural space. Unless precise attention is paid to detection of the catheter tip location, a thoracic paravertebral catheter can enter into the epidural space even under ultrasound guidance.

File： Yoshida(2016,J Anes).pdf

DOI： 10.1007/s00540-016-2170-9

Ultrasound-guided ilioinguinal/iliohypogastric block did not reduce emergence delirium after ambulatory pediatric inguinal hernia repair: a prospective randomized double-blind study Reviewed

Nobuko Ohashi, Sadahei Denda, Kenta Furutani, Takayuki Yoshida, Yoshinori Kamiya, Reiko Komura, Hironobu Nishimaki, Yasushi Iinuma, Yutaka Hirayama, Shinichi Naitou, Koju Nitta, Hiroshi Baba

SURGERY TODAY 46 ( 8 ) 963 - 969 2016.8

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

Emergence delirium (ED) is a common postoperative complication of ambulatory pediatric surgery done under general anesthesia with sevoflurane. However, perioperative analgesic techniques have been shown to reduce sevoflurane-induced ED. The primary objective of this investigation was to examine whether an ultrasound-guided ilioinguinal/iliohypogastric (II/IH) nerve block for ambulatory pediatric inguinal hernia repair could reduce the incidence of sevoflurane-induced ED.
The subjects of this prospective randomized double-blind study were 40 boys ranging in age from 1 to 6 years, who were scheduled to undergo ambulatory inguinal hernia repair. The patients were randomized to either receive or not to receive an ultrasound-guided II/IH nerve block (Group B and Group NB, respectively). General anesthesia was maintained with sevoflurane and nitrous oxide. The primary outcome assessed was ED, evaluated using the Pediatric Anesthesia Emergence Delirium (PAED) scale 30 min after emergence from general anesthesia. The secondary outcomes assessed were postoperative pain, evaluated using the Behavioral Observational Pain Scale (BOPS), and the amount of intra-operative sevoflurane given.
The median PAED scale scores did not differ between Groups B and NB at 30 min (P = 0.41). BOPS scores also did not differ significantly between the groups, but the mean amount of intraoperative sevoflurane given was significantly lower in Group B than in Group NB (P < 0.01).
Ultrasound-guided II/IH nerve block for ambulatory pediatric inguinal hernia repair did not reduce ED, but it did decrease the amount of intra-operative sevoflurane needed.
Clinical Trial Registration: UMIN000008586.

File：大橋（Surg Tuday,2016).pdf

DOI： 10.1007/s00595-015-1280-6

Intravenous administration of lidocaine directly acts on spinal dorsal horn and produces analgesic effect: An in vivo patch-clamp analysis Reviewed

Miyuki Kurabe, Hidemasa Furue, Tatsuro Kohno

SCIENTIFIC REPORTS 6 26253 2016.5

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

Intravenous lidocaine administration produces an analgesic effect in various pain states, such as neuropathic and acute pain, although the underlying mechanisms remains unclear. Here, we hypothesized that intravenous lidocaine acts on spinal cord neurons and induces analgesia in acute pain. We therefore examined the action of intravenous lidocaine in the spinal cord using the in vivo patch-clamp technique. We first investigated the effects of intravenous lidocaine using behavioural measures in rats. We then performed in vivo patch-clamp recording from spinal substantia gelatinosa (SG) neurons. Intravenous lidocaine had a dose-dependent analgesic effect on the withdrawal response to noxious mechanical stimuli. In the electrophysiological experiments, intravenous lidocaine inhibited the excitatory postsynaptic currents (EPSCs) evoked by noxious pinch stimuli. Intravenous lidocaine also decreased the frequency, but did not change the amplitude, of both spontaneous and miniature EPSCs. However, it did not affect inhibitory postsynaptic currents. Furthermore, intravenous lidocaine induced outward currents in SG neurons. Intravenous lidocaine inhibits glutamate release from presynaptic terminals in spinal SG neurons. Concomitantly, it hyperpolarizes postsynaptic neurons by shifting the membrane potential. This decrease in the excitability of spinal dorsal horn neurons may be a possible mechanism for the analgesic action of intravenous lidocaine in acute pain.

File： Kurabe(2016,SciRep).pdf

DOI： 10.1038/srep26253

Effective prevention of hand-foot syndrome by the consumption of dried bonito broth Reviewed

Kenya Kamimura, Yoko Shinagawa, Kohei Ogawa, Yuji Kobayashi, Hiroyuki Abe, Takeshi Yokoo, Hiroteru Kamimura, Hirokazu Kawai, Takeshi Suda, Satoshi Yamagiwa, Hiroshi Baba, Shuji Terai

Japanese Journal of Cancer and Chemotherapy 43 ( 4 ) 463 - 465 2016.4

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

To examine whether the consumption of dried bonito both is effective for the prevention of hand-foot syndrome (HFS), concentrated bonito broth was administered to 10 patients with HCC who were treated with sorafenib. Among the 10 patients, seven showed an increase in peripheral blood flow, as observed on Doppler ultrasonography. Only one patient showed Grade 1 HFS on day 14 after the initiation of sorafenib (10%)
this incidence rate of HFS was significantly lower than that obtained in our previous studies and reported data. These results suggest that consumption of dried bonito broth contributes to the prevention of HFS by maintaining peripheral blood flow.

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

Tatsunori Watanabe, Masayuki Sekine, Takayuki Enomoto, Hiroshi Baba

JOURNAL OF ANESTHESIA 30 ( 2 ) 317 - 319 2016.4

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

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.

File： Watanabe T(JA,2016) .pdf

DOI： 10.1007/s00540-015-2113-x

A new ultrasound-guided pubic approach for proximal obturator nerve block: clinical study and cadaver evaluation Reviewed

T. Yoshida, T. Onishi, K. Furutani, H. Baba

ANAESTHESIA 71 ( 3 ) 291 - 297 2016.3

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

We evaluated an alternative technique for ultrasound-guided proximal level obturator nerve block that might facilitate needle visualisation using in-plane ultrasound guidance. Twenty patients undergoing transurethral bladder tumour resection requiring an obturator nerve block were enrolled into a prospective observational study. With the patient in the lithotomy position, the transducer was placed on the medial thigh along the extended line of the inguinal crease, and aimed cephalad to view a thick fascia between the pectineus and obturator externus muscles that contains the obturator nerve. A stimulating nerve block needle was inserted at the pubic region and advanced in-plane with the transducer in an anterior-to-posterior direction. Eight ml levobupivacaine 0.75% was injected within the fascia. The median (IQR [range]) duration for ultrasound identification of the target and injection were 8.5 (7-12 [5-24]) s and 62 (44.5-78.25 [39-383]) s, respectively. All blocks were successful. A cadaver evaluation demonstrated that the dye injected into the target fascia using our technique travelled retrogradely through the obturator canal, and surrounded the anterior and posterior branches of the obturator nerve both proximally and distally to the obturator canal. We believe that this is a promising new technique for ultrasound-guided proximal level obturator nerve block.

File： Yoshida(Anaesthesia,2016).pdf

DOI： 10.1111/anae.13336

トラネキサム酸の脊髄後角を介する痛みの機序の解明 Reviewed

大橋宣子, 佐々木美佳, 大橋正幸, 紙谷義孝, 馬場洋, 河野達郎

PAIN RESEARCH 31 ( 1 ) 9 - 20 2016.3

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本疼痛学会

トラネキサム酸(TXA)の脊髄後角を介する痛みの機序について検討した。6〜8週齢のWistar系成熟雄性ラットを用いた。腰部脊椎(L4/5)を椎弓切除し、脊髄クモ膜下にポリエチレンカテーテルを留置した。脊髄クモ膜下投与は、術後3日以上経過してから、カテーテルより濃度の異なるTXAを投与した。腹腔内投与は、直接腹腔内へ濃度の異なるTXAを投与した。TXAは大脳皮質だけではなく、脊髄後角ニューロンへも作用し、シナプス後性にGABAAおよびグリシン受容体を直接的に抑制することで痛みを誘発した。TXAは、一次求心性線維のシナプス前終末には作用せず、興奮性介在ニューロンのGABAAおよびグリシン受容体をシナプス後性に抑制することで脱抑制を生じ、間接的に記録SGニューロンへの興奮性伝達を増強することで痛みを誘発した。TXAの灌流投与により脊髄後角浅層のpERKの発現が増加した。

File： Pain Research(2016).pdf

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J02781&link_issn=&doc_id=20160414560002&doc_link_id=%2Fci3painr%2F2016%2F003101%2F002%2F0009-0020%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fci3painr%2F2016%2F003101%2F002%2F0009-0020%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

活性酸素は脊髄前角においてN型電位依存性カルシウムチャネルの活性化を介してグルタミン酸放出を増強する

大橋正幸, 平野徹, 渡辺慶, 庄司寛和, 河野達郎, 馬場洋, 遠藤直人

日本整形外科学会雑誌 90 ( 3 ) S642 - S642 2016.3

Hydrogen peroxide modulates synaptic transmission in ventral horn neurons of the rat spinal cord Reviewed

Masayuki Ohashi, Toru Hirano, Kei Watanabe, Keiichi Katsumi, Nobuko Ohashi, Hiroshi Baba, Naoto Endo, Tatsuro Kohno

JOURNAL OF PHYSIOLOGY-LONDON 594 ( 1 ) 115 - 134 2016.1

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

Key points Excessive production of reactive oxygen species (ROS) is implicated in many central nervous system disorders; however, the physiological role of ROS in spinal ventral horn (VH) neurons remains poorly understood. We investigated how pathological levels of H2O2, an abundant ROS, regulate synaptic transmission in VH neurons of rats using a whole-cell patch clamp approach. H2O2 increased the release of glutamate and GABA from presynaptic terminals. The increase in glutamate release involved N-type voltage-gated calcium channels (VGCCs), ryanodine receptors (RyRs), and inositol trisphosphate receptors (IP(3)Rs); the increase in GABA release, which inhibited glutamatergic transmission, involved IP3R. Inhibiting N-type VGCCs and RyRs attenuates excitotoxicity resulting from increased glutamatergic activity while preserving the neuroprotective effects of GABA, and may represent a novel strategy for treating H2O2-induced motor neuron disorders resulting from trauma or ischaemia-reperfusion injury.
AbstractExcessive production of reactive oxygen species (ROS) is a critical component of the cellular and molecular pathophysiology of many central nervous system (CNS) disorders, including trauma, ischaemia-reperfusion injury, and neurodegenerative diseases. Hydrogen peroxide (H2O2), an abundant ROS, modulates synaptic transmission and contributes to neuronal damage in the CNS; however, the pathophysiological role of H2O2 in spinal cord ventral horn (VH) neurons remains poorly understood, despite reports that these neurons are highly vulnerable to oxidative stress and ischaemia. This was investigated in the present study using a whole-cell patch clamp approach in rats. We found that exogenous application of H2O2 increased the release of glutamate from excitatory presynaptic terminals and -aminobutyric acid (GABA) from inhibitory presynaptic terminals. The increase of glutamate release was induced in part by an increase in Ca2+ influx through N-type voltage-gated calcium channels (VGCCs) as well as by ryanodine receptor (RyR)- and inositol trisphosphate receptor-mediated Ca2+ release from the endoplasmic reticulum (ER). In inhibitory presynaptic neurons, increased IP3R-mediated Ca2+ release from the ER increased GABAergic transmission, which served to rescue VH neurons from excessive release of glutamate from presynaptic terminals. These findings indicate that inhibiting N-type VGCCs or RyRs may attenuate excitotoxicity resulting from increased glutamatergic activity while preserving the neuroprotective effects of GABA, and may therefore represent a novel and targeted strategy for preventing and treating H2O2-induced motor neuron disorders.
Key points Excessive production of reactive oxygen species (ROS) is implicated in many central nervous system disorders; however, the physiological role of ROS in spinal ventral horn (VH) neurons remains poorly understood. We investigated how pathological levels of H2O2, an abundant ROS, regulate synaptic transmission in VH neurons of rats using a whole-cell patch clamp approach. H2O2 increased the release of glutamate and GABA from presynaptic terminals. The increase in glutamate release involved N-type voltage-gated calcium channels (VGCCs), ryanodine receptors (RyRs), and inositol trisphosphate receptors (IP(3)Rs); the increase in GABA release, which inhibited glutamatergic transmission, involved IP3R. Inhibiting N-type VGCCs and RyRs attenuates excitotoxicity resulting from increased glutamatergic activity while preserving the neuroprotective effects of GABA, and may represent a novel strategy for treating H2O2-induced motor neuron disorders resulting from trauma or ischaemia-reperfusion injury.

File： Ohashi M(JP,2016).pdf

DOI： 10.1113/JP271449

Difficult tracheal intubation in a patient with maternal uniparental disomy 14. Reviewed International journal

Kenta Furutani, Yoshie Kodera, Masataka Hiruma, Hideaki Ishii, Hiroshi Baba

JA clinical reports 2 ( 1 ) 25 - 25 2016

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

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

パルス高周波法によるブロックが有効であった陰部神経痛の1例 Reviewed

清水大喜, 紙谷義孝, 鈴木博子, 渡邉美子, 馬場洋

日本ペインクリニック学会誌 23 ( 4 ) 551 - 554 2016

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Society of Pain Clinicians

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

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 Anesthesiology 64 ( 10 ) 1072 - 1075 2015.10

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.

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 ANESTHESIE 62 ( 10 ) 1121 - 1122 2015.10

Genetic inactivation and prolonged pharmacologic inhibition of monoacylglycerol lipase have opposite effects on anesthetic sensitivity to propofol Reviewed

Andrey B. Petrenko, Maya Yamazaki, Kenji Sakimura, Masanobu Kano, Hiroshi Baba

EUROPEAN JOURNAL OF PHARMACOLOGY 765 268 - 273 2015.10

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

Monoacylglycerol lipase (MGL) is a major enzyme involved in degradation of the endocannabinoid 2-arachidonoylglycerol (2-AG). Selective inhibitors of MGL are regarded as promising analgesics and anticancer agents. To gain insight into the possible consequences of their prolonged administration for anesthetic action, the effects of several inhalational and intravenous anesthetics were tested in knockout mice lacking the MGL gene in the loss of righting reflex (LORR) assay, Sensitivity to inhalational and most intravenous anesthetics was not altered in knockout mice. However, compared with wild-type litter-mates, they showed increased sensitivity to the intravenous anesthetic propofol. Permanently elevated levels of 2-AG after MGL knockout are known to cause desensitization of cannabinoid (CB1) receptors, which have been advocated as possible mediators of propofol anesthesia. Therefore, increased sensitivity to propofol in knockout mice at first suggested that 2-AG may potentiate CBI receptors despite their hypofunction in these animals. Pharmacologic inhibition of MGL also causes desensitization of CB1 receptors, so sensitivity to propofol was tested further in C57BL/6N mice pretreated chronically with the selective MGL inhibitor JZL 184. Contrary to the results in knockout mice, these animals showed drastically reduced sensitivity to propofol. The reason for increased sensitivity to propofol after MGL knockout remains unclear, but may result from changes occurring in these animals during development. However, our results in C57BL/6N mice pretreated with JZL 184 confirmed the role of CB1 receptors in propofol anesthesia advocated previously, and also suggest that prolonged use of MGL inhibitors may be associated with the development of resistance to propofol. (C) 2015 Elsevier B.V. All rights reserved.

File： Petrenko(Eur J Pharm,2015).pdf

DOI： 10.1016/j.ejphar.2015.08.048

痙攣の誘発にレミフェンタニルの併用が有効であった修正型電気痙攣療法の1症例 Reviewed

渡部達範, 吉永清宏, 鈴木雄太郎, 染矢俊幸, 馬場洋

麻酔 64 ( 10 ) 1072 - 1075 2015.10

Authorship：Last author,　Corresponding author Language：Japanese Publisher：克誠堂出版(株)

63歳男。28歳時に統合失調症と診断され、以後入退院を繰り返していた。今回、妄想などの症状が増悪したため当院精神科に入院したが、薬物療法に抵抗性のため修正型電気痙攣療法(mECT)の適用となった。mECT施行時に睡眠最低必要量のプロポフォール投与下で最大刺激を与えるも十分な痙攣が誘発されなかった。そこで、レミフェンタニルを併用し、プロポフォール投与量を減量したところ、有効な痙攣を誘発することができた。mECTを12回施行し、簡易精神医学的評価尺度は50点から22点に改善した。

Other Link： https://search.jamas.or.jp/link/ui/2016050373

Tranexamic acid evokes pain by modulating neuronal excitability in the spinal dorsal horn Reviewed

Nobuko Ohashi, Mika Sasaki, Masayuki Ohashi, Yoshinori Kamiya, Hiroshi Baba, Tatsuro Kohno

SCIENTIFIC REPORTS 5 13458 2015.8

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

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 gamma-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 pain-related phenomena, such as allodynia and hyperalgesia, in experimental animals. Moreover, some patients who are injected intrathecally with TXA develop severe back pain. However, the effect of TXA on spinal dorsal horn neurons remain poorly understood. Here, we investigated the effects of TXA by using behavioral measures in rats and found that TXA produces behaviors indicative of spontaneous pain and mechanical allodynia. We then performed whole-cell patch-clamp experiments that showed that TXA inhibits GABA(A) 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 GABA(A) and glycine receptors in the spinal dorsal horn.

File： Ohashi(Sci Rep,2015).pdf

DOI： 10.1038/srep13458

Anaesthesia and orphan disease: marked attenuation of motor evoked potentials by high-dose dexmedetomidine in a child with Angelman syndrome undergoing scoliosis surgery A case report with pharmacokinetic analysis Reviewed

Hideaki Ishii, Andrey B. Petrenko, Toshiyuki Tobita, Kenta Furutani, Hiroshi Baba

EUROPEAN JOURNAL OF ANAESTHESIOLOGY 32 ( 8 ) 587 - 589 2015.8

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 REPORTS 5 11191 2015.7

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.

File： Watanabe (Sci Rep,2015).pdf

DOI： 10.1038/srep11191

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 ANESTHESIE 62 ( 6 ) 671 - 673 2015.6

トラネキサム酸の脊髄後角における抑制性シナプス伝達に対する作用

大橋宣子, 佐々木美佳, 山本豪, 倉部美起, 古谷健太, 大橋正幸, 紙谷義孝, 馬場洋, 河野達郎

脊髄機能診断学 35 ( 1 ) 52 - 57 2015.1

Language：Japanese Publisher：エーザイ(株)

トラネキサム酸(TXA)の痛みに対する作用・機序について検討するため、まずラットを用いて行動学実験を行った。クモ膜下腔に留置したカテーテルよりTXAを投与して自発痛様行動を観察した結果、その持続時間は濃度依存性に延長した。次に電気生理学的実験として、脊髄後角膠様質細胞を用いてホールセルパッチクランプ記録を行い、TXAの灌流投与に対する自発性抑制性シナプス後電流(sIPSC)の反応を調べた。sIPSCの振幅はTXA投与により減少し、頻度は変化がなかった。またグリシン受容体拮抗薬のstrychnineまたはガンマアミノ酪酸(GABA)受容体拮抗薬のbicucullineを灌流投与したところ、strychnine存在下ではGABA作動性sIPSC、bicuculline存在下ではグリシン作動性sIPSCの振幅は減少した。TXAは脊髄後角ニューロンのGABAおよびグリシン受容体をシナプス後性に抑制し、それによって自発痛を増強させる可能性が示唆された。

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