Faculty Profiles - BABA Hiroshsi

Papers - BABA Hiroshsi

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倉部美起, 大橋宣子, 山本豪, 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 ) 46 - 51 2015.1

Language：Japanese Publisher：エーザイ(株)

静脈投与したリドカインの鎮痛作用の機序について、リドカインが脊髄後角ニューロンにおける興奮性シナプス伝達を修飾しているとの仮説を立て、成熟ラットの脊髄標本を用いてブラインドホールセルパッチクランプ記録による検討を行った。その結果、自発性興奮性シナプス後電流(EPSC)の発生頻度はリドカイン投与により減少し、濃度依存的、可逆的な変化を示した。振幅に関しては有意な変化がなかった。またpinch刺入による誘発性EPSCもリドカイン投与により抑制された。リドカインを脊髄表面に灌流投与した場合は、自発性EPSCの頻度・振幅とも変化はなかった。リドカインは脊髄後角ニューロンにおいてシナプス前終末からのグルタミン酸の放出を抑制し、その結果として脳への痛覚伝達が抑制され、鎮痛作用を発揮している可能性が示唆された。

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過酸化水素の脊髄前角ニューロンに対する作用の検討

大橋正幸, 河野達郎, 平野徹, 渡辺慶, 大橋宣子, 馬場洋, 遠藤直人

脊髄機能診断学 35 ( 1 ) 65 - 71 2015.1

Language：Japanese Publisher：エーザイ(株)

脊髄前角ニューロンに対する過酸化水素(H2O2)の作用機序について検討するため、ラット脊髄横断スライスを用いてホールセルパッチクランプ記録を行った。まずグルコン酸カリウムベースの電極内液を用い、保持膜電位-70mVの条件下でH2O2を灌流投与したところ、外向き電流が誘起された。その振幅はH2O2の繰り返し投与による変化は認めず、K+チャネル阻害薬であるセシウム(Cs)およびtetraethylammoniumを含んだ電極内液で有意に抑制された。またCsベースの電極内液を用いて自発性興奮性シナプス後電流の頻度と振幅を調べたところ、H2O2の灌流投与により振幅は有意な変化を認めず、頻度は一過性に増加した後に減少に転じ、減少は遷延した。電位依存性Na+チャネル阻害薬であるテトロドトキシン存在下でも、微小興奮性シナプス後電流が同様の変化を示した。

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Thoracic paravertebral block reduced the incidence of chronic postoperative pain for more than 1 year after breast cancer surgery. Reviewed

Shimizu H, Kamiya Y, Nishimaki H, Denda S, Baba H

JA clinical reports 1 ( 1 ) 19 2015

Pectoral nerve block combined with general anesthesia for breast cancer surgery: a retrospective comparison. Reviewed International journal

Morioka H, Kamiya Y, Yoshida T, Baba H

JA clinical reports 1 ( 1 ) 15 - 15 2015

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

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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The mu opioid receptor activation does not affect ischemia-induced agonal currents in rat spinal ventral horn Reviewed

Hiroyuki Honda, Hiroshi Baba, Tatsuro Kohno

JOURNAL OF ANESTHESIA 28 ( 6 ) 839 - 845 2014.12

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

Opioid-induced spastic paraplegia after transient spinal cord ischemia during aortic surgery has been reported. Opioids modulate neurotransmission through mu (mu) opioid receptors (MORs) in the spinal ventral horn. However, their effects during ischemic insult are not understood.
The effects of the selective mu agonist [d-Ala(2),-N-Me-Phe(4), Gly(5)-ol]enkephalin (DAMGO) on ischemia-induced agonal currents were examined in the spinal lamina IX neurons of neonatal rats by using the whole-cell patch-clamp technique. Ischemia was simulated in vitro by oxygen/glucose deprivation.
DAMGO (1 mu M) produced outward currents in similar to 60 % of spinal lamina IX neurons at a holding potential of -70 mV. Superfusion with ischemia-simulating medium elicited an agonal current. The latency was 457 +/- A 18 s. Despite its neuromodulatory effects, DAMGO did not significantly change the latencies of the agonal currents with (440 +/- A 23 s) or without (454 +/- A 33 s) DAMGO-induced currents.
Activation of MORs does not influence ongoing ischemia-induced neuronal death. Our findings indicate that MOR agonist administration should be suitable as an anesthetic during aortic surgery.

File： Honda(JA,2014).pdf

DOI： 10.1007/s00540-014-1829-3

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More Solid Evidence Is Required to Validate a Hypergravity-Induced Increase in Sensitivity to Propofol Reviewed

Andrey B. Petrenko, Kenta Furutani, Hiroshi Baba

ANESTHESIA AND ANALGESIA 119 ( 5 ) 1220 - 1220 2014.11

Augmented tonic pain-related behavior in knockout mice lacking monoacylglycerol lipase, a major degrading enzyme for the endocannabinoid 2-arachidonoylglycerol Reviewed

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

BEHAVIOURAL BRAIN RESEARCH 271 51 - 58 2014.9

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

Monoacylglycerol lipase (MGL) is the main enzyme responsible for degradation of the endocannabinoid 2-arachidonoylglycerol (2-AG). Selective inhibitors of MGL have antinociceptive effects upon acute administration and, therefore, hold promise as analgesics. To gain insight into the possible consequences of their prolonged administration, genetically modified mice with the knocked-out MGL gene were tested in several models of acute (phasic, tonic) and chronic (inflammatory, neuropathic) pain. MGL knockout mice showed normal acute phasic pain perception (pain thresholds) and no alleviation of pain perception in models of inflammatory and neuropathic pain. However, compared with wild-type controls, they showed significantly augmented nociceptive behavior in models of acute somatic and visceral tonic pain (formalin and acetic acid tests). The observed proalgesic changes in perception of tonic pain in MGL knockouts could have resulted from desensitization of cannabinoid receptors (known to occur after genetic inactivation of MGL). Supporting this notion, chronic pretreatment with the selective CBI receptor antagonist AM 251 (employed to re-sensitize cannabinoid receptors in MGL knockouts) resulted in normalization of their tonic pain-related behaviors. Similar augmentation of tonic pain-related behaviors was replicated in C57BL/6N mice pretreated chronically with the selective MGL inhibitor JZL 184 (employed to pharmacologically desensitize CB1 receptors). These findings imply that prolonged use of MGL inhibitors, at doses causing close to complete inhibition of MGL enzymatic activity, not only have no beneficial analgesic effects, they may lead to exacerbation of some types of pain (particularly those with a tonic component). (C) 2014 Elsevier B.V. All rights reserved.

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

DOI： 10.1016/j.bbr.2014.05.063

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陰部大腿神経大腿枝ブロックを含む末梢神経ブロックによって安全に麻酔管理ができた大腿部人工血管植込み術の１例 Reviewed

吉田敬之, 渡邉美子, 古谷健太, 山本豪, 馬場洋

臨床麻酔 38 ( 8 ) 1157-62 2014.8

脊髄前角細胞のシナプス伝達における酸化ストレスの影響 patch-clamp法による解析

大橋正幸, 河野達郎, 平野徹, 渡辺慶, 勝見敬一, 馬場洋, 遠藤直人

日本整形外科学会雑誌 88 ( 8 ) S1707 - S1707 2014.8

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

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

JOURNAL OF ANESTHESIA 28 ( 2 ) 320 - 321 2014.4

Effects of ropivacaine concentration on the spread of sensory block produced by continuous thoracic paravertebral block: a prospective, randomised, controlled, double-blind study Reviewed

T. Yoshida, T. Fujiwara, K. Furutani, N. Ohashi, H. Baba

ANAESTHESIA 69 ( 3 ) 231 - 239 2014.3

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

Factors affecting the distribution of continuous thoracic paravertebral block have never been examined. We designed this prospective, double-blind study to check whether continuous thoracic paravertebral block with a higher ropivacaine concentration would provide a wider segmental sensory block spread. Sixty consecutive patients undergoing pulmonary lobectomy or segmentectomy were randomly allocated to receive continuous paravertebral infusion of either 0.2% or 0.5% ropivacaine (6ml.h(-1)). The primary outcome was the number of anaesthetised dermatomes as determined by loss of cold sensation 24h after surgery. Twenty-seven patients per group were included in the final analysis. The median (IQR [range]) number of anaesthetised dermatomes 24h after surgery was 4 (3-6 [1-9]) with ropivacaine 0.2% and 4 (3-6 [2-11]) with ropivacaine 0.5% (p=0.66). Contrary to our expectation, the segmental spread of sensory block produced by continuous thoracic paravertebral block does not depend on ropivacaine concentration.

DOI： 10.1111/anae.12531

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

Andrey B. Petrenko, Tatsunori Watanabe, Hiroshi Baba

ANESTHESIA AND ANALGESIA 118 ( 2 ) 484 - 484 2014.2

Anesthetic management in a patient with giant growing teratoma syndrome: A case report Reviewed

Nobuko Ohashi, Hidekazu Imai, Toshiyuki Tobita, Hideaki Ishii, Hiroshi Baba

Journal of Medical Case Reports 8 ( 1 ) 2014.1

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

Introduction. Growing teratoma syndrome is a rare occurrence with an ovarian tumor. Anesthesia has been reported to be difficult in cases of growing teratoma syndrome of the cystic type due to the pressure exerted by the tumor. However, there have been no similar reports with the solid mass type. Here, we report our experience of anesthesia in a case of growing teratoma syndrome of the solid type. Case presentation. The patient was a 30-year-old Japanese woman who had been diagnosed with an ovarian immature teratoma at age 12 and had undergone surgery and chemotherapy. However, she dropped out of treatment. She presented to our hospital with a 40cm giant solid mass and severe respiratory failure, and was scheduled for an operation. We determined that we could not obtain a sufficient tidal volume without spontaneous respiration. Therefore, we chose to perform awake intubation and not to use a muscle relaxant before the operation. At the start of the operation, when muscle relaxant was first administered, we could not obtain a sufficient tidal volume. An abdominal midline incision was performed immediately and her tidal volume recovered. Her resected tumor weighed 10.5kg. After removal of her tumor, her tidal volume was maintained at a level consistent with that under spontaneous respiration to avoid occurrence of re-expansion pulmonary edema. Conclusions: We performed successful anesthetic management of a case of growing teratoma syndrome with a giant abdominal tumor. Respiratory management was achieved by avoiding use of a muscle relaxant before the operation to maintain spontaneous respiration and by maintaining a relatively low tidal volume, similar to that during spontaneous respiration preoperatively, after removal of the tumor to prevent re-expansion pulmonary edema. © 2014Ohashi et al.
licensee BioMed Central Ltd.

File： Ohash(J Med Case Rep,2014).pdf

DOI： 10.1186/1752-1947-8-32

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Defining the role of NMDA receptors in anesthesia: Are we there yet? Reviewed

Andrey B. Petrenko, Tomohiro Yamakura, Kenji Sakimura, Hiroshi Baba

EUROPEAN JOURNAL OF PHARMACOLOGY 723 29 - 37 2014.1

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

N-methyl-D-aspartate (NMDA) receptors are important in mediating excitatory neurotransmission in the nervous system. They are preferentially inhibited by some general anesthetics and have, therefore, been implied in the mediation of their effects. This review summarizes the main research findings available related to NMDA receptors and their role in anesthesia. The contribution of NMDA receptors to the anesthetized state is discussed separately for each of its components: amnesia, analgesia, Unconsciousness and immobility. Anesthetic-induced unconsciousness and immobility have received the most attention in the research community and are the main focus of this review. In the overall perspective, however, studies using pharmacological or electrophysiological approaches have Wed to reach definitive conclusions regarding the contribution of NMDA receptors to these anesthetic endpoints. None of the studies have specifically addressed the role of NMDA receptors in the amnestic effect of general anesthetics, and the Few available data are (at best) only indirect. NMDA receptor antagonism by general anesthetics may have a preventive anti-hyperalgesic effect. The only and most extensively used genetic tool to examine the role of NMDA receptors in anesthesia is global knockout of the GluN2A subunit of the NMDA receptor. These animals are resistant to many intravenous and inhalational anesthetics, but the interpretation of their phenotype is hindered by the secondary changes occurring in these animals after GluN2A knockout, which are themselves capable of altering anesthetic sensitivity. Generation of more sophisticated conditional knockout models targeting NMDA receptors is required to finally define their role in the mechanisms of anesthesia. (C) 2013 Elsevier B.V. All rights reserved.

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

DOI： 10.1016/j.ejphar.2013.11.039

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Effects of hydrogen peroxide on neonatal rat spinal ventral horn neurons Reviewed

Ohashi M, Kohno T, Hirano T, Watanabe K, Ohashi N, Baba H, Endoh N

The Journal of Functional Diagnosis of the Spinal Cord 35 ( 1 ) 65 - 71 2014

Effect of tranexamic acid on inhibitory synaptic transmission in spinal dorsal horn neurons Reviewed

Ohashi N, Sasaki M, Yamamoto G, Kurabe M, Furutani K, Ohashi M, Kamiya Y, Kohno T, Baba H

The Journal of Functional Diagnosis of the Spinal Cord 35 ( 1 ) 52 - 57 2014

Effects of dehydroepiandrosterone sulfate on pain transmission in the rat dorsal horn Reviewed

Yamamoto G, Ikoma M, Sasaki M, Ohashi N, Kurabe M, Furutani K, Kamiya Y, Baba H

The Journal of Functional Diagnosis of the Spinal Cord 35 ( 1 ) 58 - 64 2014

Intravenous administration of lidocaine inhibits excitatory synaptic transmission in spinal dorsal neurons Reviewed

Kurabe M, Ohashi N, Yamamoto G, Furutani K, Ohashi M, Kamiya Y, Kohno T, Baba H

The Journal of Functional Diagnosis of the Spinal Cord 35 ( 1 ) 46 - 51 2014

Anesthetic Management of Scoliosis Surgery for a Patient with Congenital Myasthenic Syndrome Reviewed

Misa Emura, Hideaki Ishii, Hiroshi Baba

Japanese Journal of Anesthesiology 63 ( 8 ) 911 - 914 2014

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

Congenital myasthenic syndromes (CMS) are heterogeneous disorders of neurotransmission caused by genetic mutations of neuromuscular junction molecules. We report anesthetic management of a CMS patient who was a 14-year-old boy with endplate acetylcholinesterase deficiency. The patient used noninvasive positive pressure ventilation (NPPV) at night He underwent a corrective maneuver for severe scoliosis under general anesthesia. General anesthesia was maintained using propofol and remifentanil. Intraoperative mechanical ventilation remained stable. Extubation was performed on the next day and NPPV was started. Several hours later, he complained of a stomachache and intense abdominal bloating. Computed tomography revealed a massive amount of air in the stomach and intestine. He recovered from abdominal bloating the next day without treatment for decompression. Lung-thoracic compliance has been reported to decrease immediately after a corrective maneuver for scoliosis patients. In our case, we suspected a relative increase of abdominal compliance to lung-thoracic compliance as a cause of intense abdominal bloating by air injection from NPPV with his daily setting. In CMS, symptoms, therapy and contraindicated drugs vary according to the location of dysfunction. Therefore, anesthetic management according to each genotype should be designed to avoid drugs that could either trigger or worsen CMS. Intensive respiratory care is advisable after surgery.

File：江村美紗（麻酔,2014）.pdf

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神経障害性疼痛患者に対するプレガバリン用量別の鎮痛効果と副作用 Reviewed

大橋宣子, 清水大喜, 生駒美穂, 岡本学, 河野達郎, 馬場洋

日本ペインクリニック学会誌 20 ( 4 ) 500 - 502 2013.8

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

File：大橋（2013）.pdf

DOI： 10.11321/jjspc.12-0045

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