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Ohtsubo S, Ohashi M, Hirano T, Tashi H, Makino T, Minato K, Mitsuma Y, Deguchi H, Hoshino R, Ohashi N, Furutani K, Kawashima H, Watanabe K. Delayed paraparesis after posterior spinal fusion for congenital scoliosis: a case report. Spinal Cord Ser Cases 2024; 10:24. [PMID: 38632284 PMCID: PMC11024208 DOI: 10.1038/s41394-024-00639-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/03/2024] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Although multimodal intraoperative neuromonitoring (IONM), which has high sensitivity and specificity, is typically performed during spinal deformity surgery, neurological status may deteriorate with delay after surgical maneuvers. Here, we report a rare case of delayed postoperative neurological deficit (DPND) that was not detected by IONM during posterior spinal fusion (PSF) for congenital scoliosis. CASE PRESENTATION A 14-year-old male presented with congenital scoliosis associated with T3 and T10 hemivertebrae. Preoperative Cobb angle of proximal thoracic (PT) and main thoracic (MT) curves were 50° and 41°, respectively. PSF (T1-L1) without hemivertebrectomy was performed, and the curves were corrected to 31° and 21° in the PT and MT curves, respectively, without any abnormal findings in IONM, blood pressure, or hemoglobin level. However, postoperative neurological examination revealed complete loss of motor function. A revision surgery, release of the curve correction by removing the rods, was immediately performed and muscle strength completely recovered on the first postoperative day. Five days postoperatively, PSF was achieved with less curve correction (36° in the PT curve and 26° in the MT curve), without postoperative neurological deficits. DISCUSSION Possible mechanisms of DPND in our patient are spinal cord ischemia due to spinal cord traction caused by scoliosis correction and spinal cord kinking by the pedicle at the concave side. Understanding the possible mechanisms of intra- and postoperative neural injury is essential for appropriate intervention in each situation. Additionally, IONM should be continued to at least skin closure to detect DPND observed in our patient.
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Affiliation(s)
- Shuhei Ohtsubo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Masayuki Ohashi
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan.
| | - Toru Hirano
- Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma City, Japan
| | - Hideki Tashi
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Tatsuo Makino
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Keitaro Minato
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Yusuke Mitsuma
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Hiroyuki Deguchi
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Rintaro Hoshino
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Nobuko Ohashi
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Kenta Furutani
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Kei Watanabe
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
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Chen O, Jiang C, Berta T, Powell Gray B, Furutani K, Sullenger BA, Ji RR. MicroRNA let-7b enhances spinal cord nociceptive synaptic transmission and induces acute and persistent pain through neuronal and microglial signaling. Pain 2024:00006396-990000000-00548. [PMID: 38452223 DOI: 10.1097/j.pain.0000000000003206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/02/2024] [Indexed: 03/09/2024]
Abstract
ABSTRACT Secreted microRNAs (miRNAs) have been detected in various body fluids including the cerebrospinal fluid, yet their direct role in regulating synaptic transmission remains uncertain. We found that intrathecal injection of low dose of let-7b (1 μg) induced short-term (<24 hours) mechanical allodynia and heat hyperalgesia, a response that is compromised in Tlr7-/- or Trpa1-/- mice. Ex vivo and in vivo calcium imaging in GCaMP6-report mice revealed increased calcium signal in spinal cord afferent terminals and doral root ganglion/dorsal root ganglia neurons following spinal perfusion and intraplantar injection of let-7b. Patch-clamp recordings also demonstrated enhanced excitatory synaptic transmission (miniature excitatory postsynaptic currents [EPSCs]) in spinal nociceptive neurons following let-7b perfusion or optogenetic activation of axonal terminals. The elevation in spinal calcium signaling and EPSCs was dependent on the presence of toll-like receptor-7 (TLR7) and transient receptor potential ion channel subtype A1 (TRPA1). In addition, endogenous let-7b is enriched in spinal cord synaptosome, and peripheral inflammation increased let-7b in doral root ganglion/dorsal root ganglia neurons, spinal cord tissue, and the cerebrospinal fluid. Notably, let-7b antagomir inhibited inflammatory pain and inflammation-induced synaptic plasticity (EPSC increase), suggesting an endogenous role of let-7b in regulating pain and synaptic transmission. Furthermore, intrathecal injection of let-7b, at a higher dose (10 μg), induced persistent mechanical allodynia for >2 weeks, which was abolished in Tlr7-/- mice. The high dose of let-7b also induced microgliosis in the spinal cord. Of interest, intrathecal minocycline only inhibited let-7b-induced mechanical allodynia in male but not female mice. Our findings indicate that the secreted microRNA let-7b has the capacity to provoke pain through both neuronal and glial signaling, thereby establishing miRNA as an emerging neuromodulator.
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Affiliation(s)
- Ouyang Chen
- Department of Anesthesiology, Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
- Department of Cell Biology, Duke University Medical Center, Durham, NC, United States
| | - Changyu Jiang
- Department of Anesthesiology, Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
| | - Temugin Berta
- Department of Anesthesiology, Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
- Department of Anesthesiology, Pain Research Center, University of Cincinnati Medical Center, Cincinnati, OH, United States
| | - Bethany Powell Gray
- Department of Surgery, Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kenta Furutani
- Department of Anesthesiology, Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
| | - Bruce A Sullenger
- Department of Surgery, Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States
| | - Ru-Rong Ji
- Department of Anesthesiology, Center for Translational Pain Medicine, Duke University Medical Center, Durham, NC, United States
- Department of Cell Biology, Duke University Medical Center, Durham, NC, United States
- Department of Neurobiology, Duke University Medical Center, Durham, NC, United States
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Zhao J, Bang S, Furutani K, McGinnis A, Jiang C, Roberts A, Donnelly CR, He Q, James ML, Berger M, Ko MC, Wang H, Palmiter RD, Ji RR. PD-L1/PD-1 checkpoint pathway regulates hippocampal neuronal excitability and learning and memory behavior. Neuron 2023; 111:2709-2726.e9. [PMID: 37348508 PMCID: PMC10529885 DOI: 10.1016/j.neuron.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/15/2023] [Accepted: 05/25/2023] [Indexed: 06/24/2023]
Abstract
Programmed death protein 1 (PD-1) and its ligand PD-L1 constitute an immune checkpoint pathway. We report that neuronal PD-1 signaling regulates learning/memory in health and disease. Mice lacking PD-1 (encoded by Pdcd1) exhibit enhanced long-term potentiation (LTP) and memory. Intraventricular administration of anti-mouse PD-1 monoclonal antibody (RMP1-14) potentiated learning and memory. Selective deletion of PD-1 in excitatory neurons (but not microglia) also enhances LTP and memory. Traumatic brain injury (TBI) impairs learning and memory, which is rescued by Pdcd1 deletion or intraventricular PD-1 blockade. Conversely, re-expression of Pdcd1 in PD-1-deficient hippocampal neurons suppresses memory and LTP. Exogenous PD-L1 suppresses learning/memory in mice and the excitability of mouse and NHP hippocampal neurons through PD-1. Notably, neuronal activation suppresses PD-L1 secretion, and PD-L1/PD-1 signaling is distinctly regulated by learning and TBI. Thus, conditions that reduce PD-L1 levels or PD-1 signaling could promote memory in both physiological and pathological conditions.
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Affiliation(s)
- Junli Zhao
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Sangsu Bang
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Kenta Furutani
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Aidan McGinnis
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Changyu Jiang
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Alexus Roberts
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Christopher R Donnelly
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Qianru He
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Michael L James
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Miles Berger
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | - Mei-Chuan Ko
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Haichen Wang
- Department of Neurology, Duke University Medical Center, Durham, NC 27710, USA
| | - Richard D Palmiter
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA; Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Ru-Rong Ji
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA; Department of Cell Biology, Duke University Medical Center, Durham, NC 27710, USA; Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA.
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Furutani K, Chen O, McGinnis A, Wang Y, Serhan CN, Hansen TV, Ji RR. Novel proresolving lipid mediator mimetic 3-oxa-PD1n-3 docosapentaenoic acid reduces acute and chronic itch by modulating excitatory and inhibitory synaptic transmission and astroglial secretion of lipocalin-2 in mice. Pain 2023; 164:1340-1354. [PMID: 36378290 PMCID: PMC10182233 DOI: 10.1097/j.pain.0000000000002824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
ABSTRACT Specialized proresolving mediators (SPMs) have demonstrated potent analgesic actions in animal models of pathological pain. The actions of SPMs in acute and chronic itch are currently unknown. Recently, n-3 docosapentaenoic acid (DPA) was found to be a substrate for the biosynthesis of several novel families of SPMs and 3-oxa-PD1 n-3 DPA (3-oxa-PD1) is an oxidation-resistant metabolic stable analogue of the n-3 DPA-derived protectin D1 (PD1). In this article, we demonstrate that 3-oxa-PD1 effectively reduces both acute and chronic itch in mouse models. Intrathecal injection of 3-oxa-PD1 (100 ng) reduced acute itch induced by histamine, chloroquine, or morphine. Furthermore, intrathecal 3-oxa-PD1 effectively reduced chronic itch, induced by cutaneous T-cell lymphoma (CTCL), allergic contact dermatitis with dinitrofluorobenzene, and psoriasis by imiquimod. Intratumoral injection of 3-oxa-PD1 also suppressed CTCL-induced chronic itch. Strikingly, the antipruritic effect lasted for several weeks after 1-week intrathecal 3-oxa-PD1 treatment. Whole-cell recordings revealed significant increase in excitatory postsynaptic currents in spinal dorsal horn (SDH) neurons of CTCL mice, but this increase was blocked by 3-oxa-PD1. 3-oxa-PD1 further increased inhibitory postsynaptic currents in SDH neurons of CTCL mice. Cutaneous T-cell lymphoma increased the spinal levels of lipocalin-2 (LCN2), an itch mediator produced by astrocytes. 3-oxa-PD1 suppressed LCN2 production in CTCL mice and LCN2 secretion in astrocytes. Finally, CTCL-induced anxiety was alleviated by intrathecal 3-oxa-PD1. Our findings suggest that 3-oxa-PD1 potently inhibits acute and chronic itch through the regulation of excitatory or inhibitory synaptic transmission and astroglial LCN2 production. Therefore, stable SPM analogs such as 3-oxa-PD1 could be useful to treat pruritus associated with different skin injuries.
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Affiliation(s)
- Kenta Furutani
- Center for Translational Pain Medicine, Department of Anesthesiology, and Department of Neurobiology, Duke University Medical Center, Durham, NC 27710
| | - Ouyang Chen
- Center for Translational Pain Medicine, Department of Anesthesiology, and Department of Neurobiology, Duke University Medical Center, Durham, NC 27710
- Department of Cell Biology, Duke University Medical Center, Durham, NC 27710
| | - Aidan McGinnis
- Center for Translational Pain Medicine, Department of Anesthesiology, and Department of Neurobiology, Duke University Medical Center, Durham, NC 27710
| | - Yuqing Wang
- Center for Translational Pain Medicine, Department of Anesthesiology, and Department of Neurobiology, Duke University Medical Center, Durham, NC 27710
| | - Charles N Serhan
- Center for Experimental Therapeutics and Reperfusion Injury, Department of Anesthesiology, Perioperative and Pain Medicine, Hale Building for Transformative Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, 02115
| | - Trond Vidar Hansen
- Department of Pharmacy, Section for Pharmaceutical Chemistry, University of Oslo, PO Box 1068 Blindern, N-0316 Oslo, Norway
| | - Ru-Rong Ji
- Center for Translational Pain Medicine, Department of Anesthesiology, and Department of Neurobiology, Duke University Medical Center, Durham, NC 27710
- Department of Cell Biology, Duke University Medical Center, Durham, NC 27710
- Department of Neurobiology, Duke University Medical Center, Durham, NC 27710
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Chen O, He Q, Han Q, Furutani K, Gu Y, Olexa M, Ji RR. Mechanisms and treatments of neuropathic itch in a mouse model of lymphoma. J Clin Invest 2023; 133:160807. [PMID: 36520531 PMCID: PMC9927942 DOI: 10.1172/jci160807] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Our understanding of neuropathic itch is limited due to a lack of relevant animal models. Patients with cutaneous T cell lymphoma (CTCL) experience severe itching. Here, we characterize a mouse model of chronic itch with remarkable lymphoma growth, immune cell accumulation, and persistent pruritus. Intradermal CTCL inoculation produced time-dependent changes in nerve innervations in lymphoma-bearing skin. In the early phase (20 days), CTCL caused hyperinnervations in the epidermis. However, chronic itch was associated with loss of epidermal nerve fibers in the late phases (40 and 60 days). CTCL was also characterized by marked nerve innervations in mouse lymphoma. Blockade of C-fibers reduced pruritus at early and late phases, whereas blockade of A-fibers only suppressed late-phase itch. Intrathecal (i.t.) gabapentin injection reduced late-phase, but not early-phase, pruritus. IL-31 was upregulated in mouse lymphoma, whereas its receptor Il31ra was persistently upregulated in Trpv1-expressing sensory neurons in mice with CTCL. Intratumoral anti-IL-31 treatment effectively suppressed CTCL-induced scratching and alloknesis (mechanical itch). Finally, i.t. administration of a TLR4 antagonist attenuated pruritus in early and late phases and in both sexes. Collectively, we have established a mouse model of neuropathic and cancer itch with relevance to human disease. Our findings also suggest distinct mechanisms underlying acute, chronic, and neuropathic itch.
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Affiliation(s)
- Ouyang Chen
- Center for Translational Pain Medicine, Department of Anesthesiology,,Department of Cell Biology, and
| | - Qianru He
- Center for Translational Pain Medicine, Department of Anesthesiology
| | - Qingjian Han
- Center for Translational Pain Medicine, Department of Anesthesiology
| | - Kenta Furutani
- Center for Translational Pain Medicine, Department of Anesthesiology
| | - Yun Gu
- Center for Translational Pain Medicine, Department of Anesthesiology
| | - Madelynne Olexa
- Center for Translational Pain Medicine, Department of Anesthesiology
| | - Ru-Rong Ji
- Center for Translational Pain Medicine, Department of Anesthesiology,,Department of Cell Biology, and,Department of Neurobiology, Duke University Medical Center, Durham, North Carolina, USA
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Fujita Y, Mera H, Watanabe T, Furutani K, Kondo HO, Wakai T, Kawashima H, Ogose A. Significantly earlier ambulation and reduced risk of near-falls with continuous infusion nerve blocks: a retrospective pilot study of adductor canal block compared to femoral nerve block in total knee arthroplasty. BMC Musculoskelet Disord 2022; 23:768. [PMID: 35953812 PMCID: PMC9373377 DOI: 10.1186/s12891-022-05735-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 07/29/2022] [Indexed: 12/14/2022] Open
Abstract
Background Near-falls should be detected to prevent falls related to the earlier ambulation after Total knee arthroplasty (TKA). The quadriceps weakness with femoral nerve block (FNB) has led to a focus on adductor canal block (ACB). We purposed to examine the risk of falls and the earlier ambulation in each continuous infusion nerve block. Methods Continuous infusion nerve block (FNB or ACB) was performed until postoperative day (POD) 2 or 3. Pain levels and falls/near-falls with knee-buckling were monitored from POD 1 to POD 3. The score on the manual muscle test, MMT (0 to 5, 5 being normal), of the patients who could ambulate on POD 1, was investigated. Results A total of 73 TKA cases, 36 FNB and 37 ACB, met the inclusion criteria. No falls were noted. But episodes of near-falls with knee-buckling were witnessed in 14 (39%) cases in the FNB group and in 4 (11%) in the ACB group (p = 0.0068). In the ACB group, 81.1% of patients could ambulate with parallel bars on POD 1, while only 44.4% of FNB patients could do so (p = 0.0019). The quadriceps MMT values in the ACB group was 2.82, significantly higher than 1.97 in the FNB group (p = 0.0035). There were no significant differences in pain as measured with a numerical rating scale (NRS) and rescue analgesia through POD 3. Conclusion ACB was associated with significantly less knee-buckling and earlier ambulation post-TKA, with better quadriceps strength. Our study indicated the incidence of falls and near-falls with continuous infusion nerve blocks, and support the use of ACB to reduce the risk of falls after TKA. It is suggested that a certain number of the patients even with continuous ACB infusion should be considered with the effect of motor branch to prevent falls. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05735-6.
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Affiliation(s)
- Yutaka Fujita
- Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Uonuma Kikan Hospital, 4132 Urasa, Minami-Uonuma, Niigata, 949-7302, Japan.,Present Address: Department of Orthopedic Surgery, Nagaoka Chuo General Hospital, 2041, Kawasaki-machi, Nagaoka City, Niigata, 940-8653, Japan
| | - Hisashi Mera
- Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Uonuma Kikan Hospital, 4132 Urasa, Minami-Uonuma, Niigata, 949-7302, Japan.
| | - Tatsunori Watanabe
- Department of Anesthesiology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Uonuma Kikan Hospital, 4132 Urasa, Minami-Uonuma, Niigata, 949-7302, Japan
| | - Kenta Furutani
- Department of Anesthesiology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Uonuma Kikan Hospital, 4132 Urasa, Minami-Uonuma, Niigata, 949-7302, Japan.,Present Address: Department of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 754, Ichibancho, Asahimachidori, Chuo-ku, Niigata, 951-8211, Japan
| | - Haruna O Kondo
- Division of Rehabilitation, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Uonuma Kikan Hospital, 4132 Urasa, Minami-Uonuma, Niigata, 949-7302, Japan
| | - Takao Wakai
- Division of Rehabilitation, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Uonuma Kikan Hospital, 4132 Urasa, Minami-Uonuma, Niigata, 949-7302, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, 754, Ichibancho, Asahimachidori, Chuo-ku, Niigata, 951-8211, Japan
| | - Akira Ogose
- Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Uonuma Kikan Hospital, 4132 Urasa, Minami-Uonuma, Niigata, 949-7302, Japan
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Kita T, Furutani K, Baba H. Epidural administration of 2% Mepivacaine after spinal anesthesia does not prevent intraoperative nausea and vomiting during cesarean section: A prospective, double-blinded, randomized controlled trial. Medicine (Baltimore) 2022; 101:e29709. [PMID: 35777058 PMCID: PMC9239613 DOI: 10.1097/md.0000000000029709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Intraoperative nausea and vomiting (IONV) is a common symptom during cesarean section (CS) delivery causing significant discomfort to patients. Combined spinal and epidural anesthesia (CSEA) can provide both intraoperative anesthesia and postoperative analgesia. During CSEA, it is reasonable to administer local anesthetics to the epidural space before patient complaints to compensate for the diminished effect of spinal anesthesia. Therefore, we hypothesized that intraoperative epidural administration of 2% mepivacaine would reduce the incidence of IONV. METHODS Patients who were scheduled for elective CS were randomly allocated to 2 groups. Patients and all clinical staff except for an attending anesthesiologist were blinded to the allocation. After the epidural catheter was inserted at the T11-12 or T12-L1 interspace, spinal anesthesia was performed at the L2-3 or L3-4 interspace to intrathecally administer 10 mg of 0.5% hyperbaric bupivacaine. Twenty min after spinal anesthesia, either 5 mL of 2% mepivacaine (group M) or saline (group S) was administered through an epidural catheter. Vasopressors were administered prophylactically to keep both the systolic blood pressure ≥ 80 % of the baseline value with the absolute value ≥ 90 mm Hg and the mean blood pressure ≥ 60 mm Hg. The primary endpoint was the incidence of IONV. The secondary endpoints were degree of nausea, the degree and incidence of pain, and Bromage score. RESULTS Ninety patients were randomized, and 3 patients were excluded from the final analysis. There was no significant difference in the incidence of IONV between the groups (58% in group M and 61% in group S, respectively, P = .82). In contrast, the incidence and degree of intraoperative pain in group M were significantly lower compared to group S. In addition, the incidence of rescue epidural administration of fentanyl (18% vs 47%) or mepivacaine (2.3% vs 25%) for intraoperative pain was lower in group M compared to group S. CONCLUSIONS Our results indicate that epidural administration of 2% mepivacaine 20 minutes after spinal anesthesia does not reduce the incidence of IONV in CS under CSEA. However, intraoperative epidural administration of 2% mepivacaine was found to improve intraoperative pain.
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Affiliation(s)
- Takayuki Kita
- Department of Anesthesiology, Uonuma Kikan Hospital, Minami-Uonuma, Niigata 949-7302, Japan
| | - Kenta Furutani
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
- *Correspondence: Kenta Furutani, Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-Dori, Chuo-ku, Niigata 951-8520, Japan (e-mail: )
| | - Hiroshi Baba
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
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Furutani K, Ji RR. Targeting Hv1 proton channel for pain control. Cell Res 2022; 32:419-420. [PMID: 35365754 PMCID: PMC9061828 DOI: 10.1038/s41422-022-00648-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Kenta Furutani
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Ru-Rong Ji
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.
- Department of Neurobiology, Duke University Medical Center, Durham, NC, USA.
- Department of Cell Biology, Duke University Medical Center, Durham, NC, USA.
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Luo X, Chen O, Wang Z, Bang S, Ji J, Lee SH, Huh Y, Furutani K, He Q, Tao X, Ko MC, Bortsov A, Donnelly CR, Chen Y, Nackley A, Berta T, Ji RR. IL-23/IL-17A/TRPV1 axis produces mechanical pain via macrophage-sensory neuron crosstalk in female mice. Neuron 2021; 109:2691-2706.e5. [PMID: 34473953 DOI: 10.1016/j.neuron.2021.06.015] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/16/2021] [Accepted: 06/14/2021] [Indexed: 12/16/2022]
Abstract
Although sex dimorphism is increasingly recognized as an important factor in pain, female-specific pain signaling is not well studied. Here we report that administration of IL-23 produces mechanical pain (mechanical allodynia) in female but not male mice, and chemotherapy-induced mechanical pain is selectively impaired in female mice lacking Il23 or Il23r. IL-23-induced pain is promoted by estrogen but suppressed by androgen, suggesting an involvement of sex hormones. IL-23 requires C-fiber nociceptors and TRPV1 to produce pain but does not directly activate nociceptor neurons. Notably, IL-23 requires IL-17A release from macrophages to evoke mechanical pain in females. Low-dose IL-17A directly activates nociceptors and induces mechanical pain only in females. Finally, deletion of estrogen receptor subunit α (ERα) in TRPV1+ nociceptors abolishes IL-23- and IL-17-induced pain in females. These findings demonstrate that the IL-23/IL-17A/TRPV1 axis regulates female-specific mechanical pain via neuro-immune interactions. Our study also reveals sex dimorphism at both immune and neuronal levels.
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Affiliation(s)
- Xin Luo
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.
| | - Ouyang Chen
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA; Department of Cell Biology, Duke University Medical Center, Durham, NC, USA
| | - Zilong Wang
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Sangsu Bang
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Jasmine Ji
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Sang Hoon Lee
- Pain Research Center, Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Yul Huh
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA; Department of Cell Biology, Duke University Medical Center, Durham, NC, USA
| | - Kenta Furutani
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Qianru He
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Xueshu Tao
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Mei-Chuan Ko
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Andrey Bortsov
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Christopher R Donnelly
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Yong Chen
- Department of Neurology, Duke University Medical Center, Durham, NC, USA
| | - Andrea Nackley
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA; Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, USA
| | - Temugin Berta
- Pain Research Center, Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ru-Rong Ji
- Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA; Department of Cell Biology, Duke University Medical Center, Durham, NC, USA; Department of Neurobiology, Duke University Medical Center, Durham, NC, USA.
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10
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Furutani K, Deguchi H, Matsuhashi M, Mitsuma Y, Kamiya Y, Baba H. A Bolus Dose of Ketamine Reduces the Amplitude of the Transcranial Electrical Motor-evoked Potential: A Randomized, Double-blinded, Placebo-controlled Study. J Neurosurg Anesthesiol 2021; 33:230-238. [PMID: 31633576 DOI: 10.1097/ana.0000000000000653] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 08/30/2019] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Kenta Furutani
- Department of Anesthesiology, Niigata University Medical and Dental Sciences, Niigata, Japan
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11
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Sasaki M, Kamiya Y, Bamba K, Onishi T, Matsuda K, Kohno T, Kurabe M, Furutani K, Yanagimura H. Serotonin Plays a Key Role in the Development of Opioid-Induced Hyperalgesia in Mice. J Pain 2021; 22:715-729. [PMID: 33465503 DOI: 10.1016/j.jpain.2020.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 01/02/2023]
Abstract
Opioid usage for pain therapy is limited by its undesirable clinical effects, including paradoxical hyperalgesia, also known as opioid-induced hyperalgesia (OIH). However, the mechanisms associated with the development and maintenance of OIH remain unclear. Here, we investigated the effect of serotonin inhibition by the 5-HT3 receptor antagonist, ondansetron (OND), as well as serotonin deprivation via its synthesis inhibitor para-chlorophenylalanine, on mouse OIH models, with particular focus on astrocyte activation. Co-administering of OND and morphine, in combination with serotonin depletion, inhibited mechanical hyperalgesia and astrocyte activation in the spinal dorsal horn of mouse OIH models. Although previous studies have suggested that activation of astrocytes in the spinal dorsal horn is essential for the development and maintenance of OIH, herein, treatment with carbenoxolone (CBX), a gap junction inhibitor that suppresses astrocyte activation, did not ameliorate mechanical hyperalgesia in mouse OIH models. These results indicate that serotonin in the spinal dorsal horn, and activation of the 5-HT3 receptor play essential roles in OIH induced by chronic morphine, while astrocyte activation in the spinal dorsal horn serves as a secondary effect of OIH. Our findings further suggest that serotonergic regulation in the spinal dorsal horn may be a therapeutic target of OIH. PERSPECTIVE: The current study revealed that the descending serotonergic pain-facilitatory system in the spinal dorsal horn is crucial in OIH, and that activation of astrocytes is a secondary phenotype of OIH. Our study offers new therapeutic targets for OIH and may help reduce inappropriate opioid use.
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Affiliation(s)
- Mika Sasaki
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Yoshinori Kamiya
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan.
| | - Keiko Bamba
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Takeshi Onishi
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Keiichiro Matsuda
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Tatsuro Kohno
- Department of Anesthesiology, International University of Health and Welfare, Narita City, Japan
| | - Miyuki Kurabe
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Kenta Furutani
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
| | - Harue Yanagimura
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Japan
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12
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Deguchi H, Furutani K, Mitsuma Y, Kamiya Y, Baba H. Propofol reduces the amplitude of transcranial electrical motor-evoked potential without affecting spinal motor neurons: a prospective, single-arm, interventional study. J Anesth 2021; 35:434-441. [PMID: 33825982 DOI: 10.1007/s00540-021-02927-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/22/2021] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Hiroyuki Deguchi
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-Dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Kenta Furutani
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-Dori, Chuo-ku, Niigata, 951-8520, Japan.
| | - Yusuke Mitsuma
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-Dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Yoshinori Kamiya
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-Dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Hiroshi Baba
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-Dori, Chuo-ku, Niigata, 951-8520, Japan
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13
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Furutani K, Tobita T, Ishii H, Deguchi H, Mitsuma Y, Kamiya Y, Baba H. Epidural Administration of Ropivacaine Reduces the Amplitude of Transcranial Electrical Motor-Evoked Potentials: A Double-Blinded, Randomized, Controlled Trial. Anesth Analg 2021; 132:1092-1100. [PMID: 33060493 DOI: 10.1213/ane.0000000000005236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
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.
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Affiliation(s)
- Kenta Furutani
- From the Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Toshiyuki Tobita
- Department of Anesthesiology, Saiseikai Niigata Hospital, Niigata, Japan
| | - Hideaki Ishii
- Department of Anesthesiology, Nagaoka Chuo General Hospital, Nagaoka City, Japan
| | - Hiroyuki Deguchi
- From the Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yusuke Mitsuma
- From the Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yoshinori Kamiya
- From the Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Hiroshi Baba
- From the Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata, Japan
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Furutani K, Watanabe T, Matsuda K, Kamiya Y, Baba H. SUZYTM forceps facilitate nasogastric tube insertion under McGRATHTM MAC videolaryngoscopic guidance: A randomized, controlled trial. Medicine (Baltimore) 2020; 99:e22545. [PMID: 33031298 PMCID: PMC10545345 DOI: 10.1097/md.0000000000022545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/13/2020] [Accepted: 09/03/2020] [Indexed: 11/26/2022] Open
Abstract
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.
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Affiliation(s)
- Kenta Furutani
- Department of Anesthesiology, Niigata University Medical and Dental Hospital
| | - Tatsunori Watanabe
- Department of Anesthesiology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-Uonuma, Niigata, Japan
| | - Keiichiro Matsuda
- Department of Anesthesiology, Niigata University Medical and Dental Hospital
| | - Yoshinori Kamiya
- Department of Anesthesiology, Niigata University Medical and Dental Hospital
| | - Hiroshi Baba
- Department of Anesthesiology, Niigata University Medical and Dental Hospital
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15
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Soma H, Furutani K, Hibino A, Hibino A, Baba H. Downfolding of the epiglottis into the laryngeal inlet after tracheal intubation using the McGRATH TM MAC videolaryngoscope: a case report. JA Clin Rep 2020; 6:42. [PMID: 32504240 PMCID: PMC7275101 DOI: 10.1186/s40981-020-00349-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/27/2020] [Indexed: 11/24/2022] Open
Abstract
Background Downfolding of the epiglottis into the laryngeal inlet is considered to be a rare complication of tracheal intubation. We describe a case of epiglottic downfolding during tracheal intubation using a McGrath videolaryngoscope (McGRATHTM MAC). Case presentation A 44-year-old female was scheduled for breast reconstruction surgery. Intubation was performed using a McGrath videolaryngoscope. After intubation, videolaryngoscopy revealed that the epiglottis was inverted and folded down into the laryngeal inlet. We elevated the larynx anteriorly using the McGrath videolaryngoscope, enabling the downfolded epiglottis to be pulled out from the laryngeal inlet and restored to its original position. After surgery, the patient was extubated without any complications. Conclusions When using the McGrath videolaryngoscope, both glottic exposure similar to that achieved with the Macintosh laryngoscope and careful observation of the epiglottis should enable the prevention, detection, and treatment of epiglottic downfolding into the laryngeal inlet.
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Affiliation(s)
- Haruno Soma
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan
| | - Kenta Furutani
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan.
| | - Ayaka Hibino
- Department of Anesthesiology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 951-8550, Japan
| | - Akinobu Hibino
- Department of Anesthesiology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 951-8550, Japan
| | - Hiroshi Baba
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan
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Furutani K, Matsuhashi M, Deguchi H, Mitsuma Y, Ohashi N, Baba H. Marked attenuation of the amplitude of transcranial motor-evoked potentials after intravenous bolus administration of ketamine: a case report. J Med Case Rep 2018; 12:204. [PMID: 30001750 PMCID: PMC6043957 DOI: 10.1186/s13256-018-1741-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/06/2018] [Indexed: 11/12/2022] Open
Abstract
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.
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Affiliation(s)
- Kenta Furutani
- Department of Anesthesiology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma, Niigata, 949-7302, Japan. .,Department of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata, 951-8510, Japan.
| | - Mari Matsuhashi
- Department of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Hiroyuki Deguchi
- Department of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Yusuke Mitsuma
- Department of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Nobuko Ohashi
- Department of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Hiroshi Baba
- Department of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata, 951-8510, Japan
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Ishii H, Petrenko AB, Sasaki M, Satoh Y, Kamiya Y, Tobita T, Furutani K, Matsuhashi M, Kohno T, Baba H. Free radical scavenger edaravone produces robust neuroprotection in a rat model of spinal cord injury. Brain Res 2017; 1682:24-35. [PMID: 29294349 DOI: 10.1016/j.brainres.2017.12.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 12/06/2017] [Accepted: 12/26/2017] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Hideaki Ishii
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahi-machi, Chuo-ku, Niigata 951-8510, Japan.
| | - Andrey B Petrenko
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahi-machi, Chuo-ku, Niigata 951-8510, Japan.
| | - Mika Sasaki
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahi-machi, Chuo-ku, Niigata 951-8510, Japan.
| | - Yukio Satoh
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahi-machi, Chuo-ku, Niigata 951-8510, Japan.
| | - Yoshinori Kamiya
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahi-machi, Chuo-ku, Niigata 951-8510, Japan.
| | - Toshiyuki Tobita
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahi-machi, Chuo-ku, Niigata 951-8510, Japan; Department of Anesthesiology, Saiseikai Niigata Daini Hospital, 280-7 Teraji, Nishi-ku, Niigata 950-1104, Japan.
| | - Kenta Furutani
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahi-machi, Chuo-ku, Niigata 951-8510, Japan.
| | - Mari Matsuhashi
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahi-machi, Chuo-ku, Niigata 951-8510, Japan; Department of Anesthesiology, Niigata Prefectural Central Hospital, 205 Joetsu, Shinnancho, Niigata 943-0192, Japan.
| | - Tatsuro Kohno
- Department of Anesthesiology, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyaginoku, Sendai, Miyagi 983-8512, Japan.
| | - Hiroshi Baba
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahi-machi, Chuo-ku, Niigata 951-8510, Japan.
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Ohashi M, Watanabe K, Furutani K, Hirano T, Katsumi K, Shoji H, Mizouchi T, Endo N. False-negative transcranial motor evoked potentials (TcMEPs) during surgery for congenital lumbar kyphoscoliosis: a case report. Spinal Cord Ser Cases 2017; 3:17053. [PMID: 28944085 DOI: 10.1038/scsandc.2017.53] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 06/24/2017] [Accepted: 07/10/2017] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Transcranial motor evoked potential (TcMEP) monitoring is the gold standard for intra-operative neurological monitoring (IOM) of motor pathways during complex spine surgery because of its high sensitivity and specificity. However, although it is very low, the rate of false-negatives in TcMEP monitoring is not zero. Therefore, over-reliance on TcMEP monitoring can cause potentially preventable motor deficits. CASE PRESENTATION We report a case of motor deficits due to nerve root stretch after surgical correction of a congenital lumbar kyphoscoliosis in a 56-year-old woman. TcMEPs did not show any significant changes during surgery, whereas free-run electromyography (EMG) demonstrated a long-lasting train activity in the left quadriceps femoris muscle (QF) after correction at the osteotomy area. According to the normal findings on TcMEP monitoring, we did not release the correction. Postoperatively, a significant decrease (grade 2-) in the manual muscle test for the left QF and iliopsoas muscle and hypesthesia of the left anterior thigh was revealed. Fortunately, muscle strength was fully recovered without revision surgery at 6 months postoperatively; however, numbness in the left anterior thigh persisted at 2 years after surgery. DISCUSSION Our report suggests that the possibility of false-negative TcMEPs should be kept in mind, especially during surgery with a risk of nerve root injury. When abnormal findings in the free-run EMG, including long-lasting train activity, are observed, surgeons should consider performing appropriate responses, such as the release of the correction, even when no substantial changes are seen in the TcMEPs.
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Affiliation(s)
- Masayuki Ohashi
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Kei Watanabe
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Kenta Furutani
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Toru Hirano
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Keiichi Katsumi
- Department of Orthopedic Surgery, Uonuma Kikan Hospital, Minami-Uonuma City, Niigata, Japan
| | - Hirokazu Shoji
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Tatsuki Mizouchi
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Naoto Endo
- Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
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Furutani K, Watanabe T, Kamiya Y, Baba H. Comparison of a curved forceps with a conventional straight forceps for nasogastric tube insertion under videolaryngoscopic guidance: A randomized, crossover manikin study. Medicine (Baltimore) 2017; 96:e7983. [PMID: 28858136 PMCID: PMC5585530 DOI: 10.1097/md.0000000000007983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Nasogastric tube (NGT) insertion is an easy procedure that can be routinely performed under general anesthesia. However, for difficult cases, there are limited insertion techniques available in routine clinical practice, considering the flexibility of NGTs. The SUZY curved forceps are designed for the removal of pharyngolaryngeal foreign bodies under guidance of the McGRATH MAC (McG) videolaryngoscope. Because McG enables clear visualization of the esophageal inlet, we hypothesized that the SUZY forceps can facilitate easier NGT insertion compared with the conventional Magill forceps under McG guidance and designed a randomized, crossover manikin study to test this hypothesis. MATERIALS AND METHODS Ten anesthesiologists participated in this study. Each participant was instructed to insert an NGT using either the SUZY or the Magill forceps under McG guidance. Both types of forceps were used by each participant in a computer-generated random order. The primary outcome measure was the number of "strokes" (1 stroke was defined by a specific sequence of participant actions) required to advance the NGT 30 cm from the starting point. Data are expressed as medians (interquartile ranges [ranges]). RESULTS The number of strokes required for NGT insertion was fewer in the SUZY group than in the Magill group {7 [7.0-12.5 (5-14)] vs 16.5 [13.5-20.3 (7-22)]; P <.05}. The time required for NGT insertion was also lesser in the SUZY group than in the Magill group {15.4 [13.7-20.0 (7.0-38.3)] seconds vs 30.3 [22.0-42.3 (12.8-47.5) seconds]; P <.05}. CONCLUSIONS The SUZY curved forceps facilitated NGT insertion more effectively than the Magill straight forceps under McG guidance. Our results suggest that NGT insertion using the SUZY forceps under McG guidance is a secure and easy procedure.
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Affiliation(s)
- Kenta Furutani
- Department of Anesthesiology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-Uonuma
| | - Tatsunori Watanabe
- Division of Anesthesiology, Niigata University Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Yoshinori Kamiya
- Division of Anesthesiology, Niigata University Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Hiroshi Baba
- Division of Anesthesiology, Niigata University Medical and Dental Sciences, Niigata City, Niigata, Japan
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Deufel C, McLemore L, Fong de los Santos L, Classic K, Park S, Furutani K. OC-0081: Patient Safety Is Improved With An Extensive Incident Learning System—9 Years Of Clinical Evidence. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30525-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Yoshida T, Furutani K, Watanabe Y, Ohashi N, Baba H. Analgesic efficacy of bilateral continuous transversus abdominis plane blocks using an oblique subcostal approach in patients undergoing laparotomy for gynaecological cancer: a prospective, randomized, triple-blind, placebo-controlled study. Br J Anaesth 2016; 117:812-820. [DOI: 10.1093/bja/aew339] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2016] [Indexed: 01/22/2023] Open
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22
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Mundy D, Tryggestad E, Beltran C, Furutani K, Gilson G, Ito S, Johnson J, Kruse J, Remmes N, Tasson A, Whitaker T, Herman M. SU-F-T-169: A Periodic Quality Assurance Program for a Spot-Scanning Proton Treatment Facility. Med Phys 2016. [DOI: 10.1118/1.4956306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Yoshida T, Shimizu H, Furutani K, Baba H. Unintentional epidural placement of a thoracic paravertebral catheter inserted using an ultrasound-guided technique: a case report. J Anesth 2016; 30:727-30. [PMID: 27040105 DOI: 10.1007/s00540-016-2170-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 03/27/2016] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Takayuki Yoshida
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata, Japan.
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Niigata, Niigata, 951-8510, Japan.
| | - Hiroki Shimizu
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kenta Furutani
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Niigata, Niigata, 951-8510, Japan
| | - Hiroshi Baba
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Niigata, Niigata, 951-8510, Japan
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Furutani K, Kodera Y, Hiruma M, Ishii H, Baba H. Difficult tracheal intubation in a patient with maternal uniparental disomy 14. JA Clin Rep 2016; 2:25. [PMID: 29497680 PMCID: PMC5818854 DOI: 10.1186/s40981-016-0051-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 09/16/2016] [Indexed: 12/03/2022] Open
Abstract
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.
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Affiliation(s)
- Kenta Furutani
- Division of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata 951-8510 Japan
| | - Yoshie Kodera
- Division of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata 951-8510 Japan
| | - Masataka Hiruma
- Division of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata 951-8510 Japan
| | - Hideaki Ishii
- Division of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata 951-8510 Japan
| | - Hiroshi Baba
- Division of Anesthesiology, Niigata University Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata 951-8510 Japan
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Yoshida T, Onishi T, Furutani K, Baba H. A new ultrasound-guided pubic approach for proximal obturator nerve block: clinical study and cadaver evaluation. Anaesthesia 2015; 71:291-7. [DOI: 10.1111/anae.13336] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2015] [Indexed: 11/26/2022]
Affiliation(s)
- T. Yoshida
- Department of Anesthesiology; Niigata University Medical and Dental Hospital; Niigata-city Japan
| | - T. Onishi
- Division of Anesthesiology; Niigata University Graduate School of Medical and Dental Sciences; Niigata-city Japan
| | - K. Furutani
- Division of Anesthesiology; Niigata University Graduate School of Medical and Dental Sciences; Niigata-city Japan
| | - H. Baba
- Division of Anesthesiology; Niigata University Graduate School of Medical and Dental Sciences; Niigata-city Japan
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Merrell K, Davis B, Goulet C, Furutani K, Mynderse L, Wilson T, Deufel C, Birckhead B, Choo R. PO-1039: Comparison of seed migration to the chest after permanent prostate brachytherapy with loose, stranded or mixed seeds. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41031-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Petrenko AB, Furutani K, Baba H. More Solid Evidence Is Required to Validate a Hypergravity-Induced Increase in Sensitivity to Propofol. Anesth Analg 2014; 119:1220. [DOI: 10.1213/ane.0000000000000391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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28
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Grams M, Wilson Z, Sio T, Beltran C, Tryggestad E, Gupta S, Blackwell C, McCollough K, Sarkaria J, Furutani K. SU-E-T-457: Design and Characterization of An Economical 192Ir Hemi-Brain Small Animal Irradiator. Med Phys 2014. [DOI: 10.1118/1.4888790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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29
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Yoshida T, Fujiwara T, Furutani K, Ohashi N, Baba H. Effects of ropivacaine concentration on the spread of sensory block produced by continuous thoracic paravertebral block: a prospective, randomised, controlled, double-blind study. Anaesthesia 2014; 69:231-9. [DOI: 10.1111/anae.12531] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2013] [Indexed: 11/30/2022]
Affiliation(s)
- T. Yoshida
- Division of Anesthesiology; Niigata University Graduate School of Medical and Dental Sciences; Niigata-city Japan
| | - T. Fujiwara
- Division of Anesthesiology; Niigata University Graduate School of Medical and Dental Sciences; Niigata-city Japan
| | - K. Furutani
- Division of Anesthesiology; Niigata University Graduate School of Medical and Dental Sciences; Niigata-city Japan
| | - N. Ohashi
- Division of Anesthesiology; Niigata University Graduate School of Medical and Dental Sciences; Niigata-city Japan
| | - H. Baba
- Division of Anesthesiology; Niigata University Graduate School of Medical and Dental Sciences; Niigata-city Japan
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Furutani K, Kohno T. [Antagonistic action of local anesthetics except at the sodium channel]. Masui 2013; 62:44-51. [PMID: 23431893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Local anesthetics block impulses in peripheral nerves through the inhibition of voltage-gated sodium channels. However, the effects of local anesthetics may be more complex. It has been reported that local anesthetics not only block the impulses in nerve roots, but could also interact with many membrane phospholipids and proteins, including various receptors, and thereby affect a variety of cellular activities. In fact, there is evidence indicating that local anesthetics could inhibit NMDA-induced glutamatergic transmission in the spinal cord. Therefore, NMDA receptor antagonism of local anesthetics may have the possibility to prevent the patients from developing chronic pain. Furthermore, local anesthetics might have the possibility to prevent cancer cell proliferation like NMDA receptor antagonists. Local anesthetics have also been reported to have an inhibitory effect on other ion channel-coupled receptors, including 5-HT3, GABA, glycine, and nicotinic ACh receptors. Recently, the interaction between local anesthetics and TRPV1 agonist has attracted the attention because they raise the possibilities of producing analgesic effect without affecting motor or other sensory functions. The effects of local anesthetics may have some aspects which have not been clarified. Further investigations will be required to fully understand the actions of local anesthetics.
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Affiliation(s)
- Kenta Furutani
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510
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Ohashi N, Furutani K, Ishii H, Baba H. [Perioperative brachial plexus injury caused by hyperabduction of the upper extremity in a patient with Ehlers-Danlos syndrome in the prone position]. Masui 2012; 61:626-628. [PMID: 22746029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
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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Affiliation(s)
- Nobuko Ohashi
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata 951-8520
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Nomura M, Kodaira T, Furutani K, Tachibana H, Tomita N, Goto Y. Predictive factors for radiation pneumonitis in oesophageal cancer patients treated with chemoradiotherapy without prophylactic nodal irradiation. Br J Radiol 2012; 85:813-8. [PMID: 22253344 DOI: 10.1259/bjr/13604628] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The objective of this study was to identify clinical and dosimetric factors for the development of radiation pneumonitis (RP) among patients with oesophageal cancer treated with three-dimensional radiotherapy without prophylactic nodal irradiation. METHODS 125 patients with oesophageal cancer had undergone dose-volume histogram (DVH) metrics and received chemoradiotherapy (CRT). Several clinical and dosimetric factors with regard to the lung were evaluated as predictive factors for the development of symptomatic RP. RESULTS 26 patients (20.8%) developed symptomatic RP classified as greater than or equal to Grade 2. By univariate analysis, body weight loss, tumour length, Stage IV, response to treatment and all DVH parameters proved to be significant factors for the development of RP (p < 0.05). By multivariate analysis, Stage IV and all dosimetric factors were independent predictive factors for the development of symptomatic RP (p < 0.05). Recursive partitioning analysis indicated that V10 values of 24.8% or more and Stage IV were associated with higher development of RP (odds ratio 6.53). CONCLUSIONS Our study demonstrated that severe RP was also developed in patients treated with the minimal radiation field. Stage IV and the dosimetric factors were identified as independent predictive factors for symptomatic RP in oesophageal cancer patients treated with CRT without prophylactic nodal irradiation.
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Affiliation(s)
- M Nomura
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi, Japan.
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Furutani K, Kohno T. [Local anesthetics inhibit NMDA-mediated glutamatergic transmission in spinal dorsal horn neurons]. Masui 2011; 60 Suppl:S151-S158. [PMID: 22458033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Goto Y, Ito J, Tomita N, Tachibana H, Furutani K, Kodaira T. The Clinical Outcome And Patterns Of Recurrence Of Limited Field Postoperative Radiotherapy For Squamous-cell Carcinoma Of Head and Neck. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Kasuva G, Toita T, Furutani K, Kodaira T, Ohno T, Kaneyasu Y, Yoshimura R, Uno T, Ishikura S, Hiraoka M. 8017 POSTER Distribution Patterns of Metastatic Pelvic Lymph Nodes Assessed by CT/MRI in Patients With Uterine Cervical Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72105-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Goto Y, Ito J, Tomita N, Tachibana H, Furutani K, Kodaira T. Re-irradiation Combined with Concurrent Chemotherapy for Patients with Locally Recurrent Nasopharyngeal Carcinoma: Clinical Advantage of Intensity Modulated Radiotherapy using Helical Tomotherapy. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yoshida T, Furutani K, Hashimoto T, Taneoka M, Tobita T, Baba H. [Anesthetic management of Menkes disease infant with difficult vascular access]. Masui 2010; 59:1280-1283. [PMID: 20960903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
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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Affiliation(s)
- Takayuki Yoshida
- Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata 951-8520
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Toita T, Ohno T, Kaneyasu Y, Uno T, Yoshimura R, Kodaira T, Furutani K, Kasuya G, Ishikura S, Kamura T, Hiraoka M. A Consensus-based Guideline Defining the Clinical Target Volume for Pelvic Lymph Nodes in External Beam Radiotherapy for Uterine Cervical Cancer. Jpn J Clin Oncol 2010; 40:456-63. [DOI: 10.1093/jjco/hyp191] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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39
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Hashimoto T, Asakura H, Kanemoto A, Kubota S, Ogawa H, Harada H, Furutani K, Fuji H, Murayama S, Nishimura T. Cardiac Contouring for the Assessment of Cardiac Toxicity after Chemoradiotherapy for Patients with Esophageal Cancer. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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40
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Hashii H, Mizumoto M, Harada H, Asakura H, Hashimoto T, Furutani K, Kanemoto A, Katagiri H, Nakasu Y. Radiotherapy for Patients with Symptomatic Intramedullary Spinal Cord Metastases. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Mizumoto M, Harada H, Asakura H, Hashimoto T, Furutani K, Murata H, Takagi T, Katagiri H, Takahashi M, Nishimura T. Radiotherapy for the Patients with Metastases to the Spinal Column: A Review of 603 Patients in Terms of Predictive Factors of Local Control and Survival. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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42
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Thomson R, Furutani K, Rogers D. WE-D-BRB-03: Novel Plaques for Iris Melanoma I-125 and Pd-103 Brachytherapy. Med Phys 2009. [DOI: 10.1118/1.3182517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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43
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Furutani K, Ohkuro M, Komura R, Honma T, Saito N, Baba H. [Anesthetic management of a child with congenital myotonic dystrophy and perioperative hypoxia]. Masui 2009; 58:183-186. [PMID: 19227172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
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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Affiliation(s)
- Kenta Furutani
- Division of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510
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Hashimoto T, Asakura H, Zenda S, Hashii H, Mizumoto M, Harada H, Furutani K, Fuji H, Murayama S, Nishimura T. Cardiac Toxicities after Concurrent Chemoradiotherapy for Esophageal Cancer - Dose-volume Histogram (DVH) Analysis. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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45
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Mizumoto M, Harada H, Asakura H, Hashimoto T, Furutani K, Hashii H, Takagi T, Katagiri H, Takahashi M, Nishimura T. Prognostic factors of survival after radiotherapy for metastases to the spinal column and a scoring system of survival: Review of 530 patients in Shizuoka Cancer Center Hospital. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.9608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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46
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Fuwa N, Kodaira T, Furutani K, Tachibana H, Nakamura T, Nakahara R, Tomoda T, Inokuchi H, Daimon T. Intra-arterial chemoradiotherapy for locally advanced oral cavity cancer: analysis of therapeutic results in 134 cases. Br J Cancer 2008; 98:1039-45. [PMID: 18283309 PMCID: PMC2275486 DOI: 10.1038/sj.bjc.6604272] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The objective of this study was to investigate the therapeutic results of arterial injection therapy via the superficial temporal artery for 134 cases of stages III and IV (M0) oral cavity cancer retrospectively, and to clarify the prognostic factors. We administered intra-arterial chemoradiotherapy by continuous infusion of carboplatin in 65 cases from January 1993 to July 2002. Systemic chemotherapy was performed on 26 cases at the same time. We administered intra-arterial chemoradiotherapy by cisplatin with sodium thiosulphate in 69 cases from October 2002 to December 2006. Systemic chemotherapy was performed on 48 cases at the same time. The 3-year local control rate was 68.6% (T2-3: 77.9%; T4: 51.3%), and the 3-year survival rate was 53.9% (stage III: 62.9%; stage IV: 45.3%). Regarding the results of multivariate analysis of survival rates, age (<65), selective intra-arterial infusion, and the use of cisplatin as an agent for intra-arterial infusion were significant factors. The therapeutic results of intra-arterial chemoradiotherapy via the superficial temporal artery were not inferior to the results of surgery. In particular, the results of arterial injection therapy by cisplatin with sodium thiosulphate were excellent, so we believe that it will be a new therapy for advanced oral cavity cancer.
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Affiliation(s)
- N Fuwa
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
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47
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Davis B, Goulet C, Furutani K, Mynderse L, Wilson T. MP-18.14: Seed migration rate to the chest following permanent prostate brachytherapy is markedly reduced with the use of seeds in vicryl suture material. Urology 2007. [DOI: 10.1016/j.urology.2007.06.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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48
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Minehan KJ, Furutani K, McNamara K, Groshek D, Mitchell E, Price M, Emme M, Harms T. Prostate brachytherapy post implant dosimetry: Timing matters. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.14597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
14597 Background: Permanent seed implant (PSI) brachytherapy is a common treatment modality for low-risk prostate cancer. Post implant dosimetry (PID) is utilized to asses the quality of the implant. Significant prostate swelling occurs as a result of the implant procedure, and this swelling subsides over time. PID completed on Day 0 after the implant procedure captures the prostate swelling from the procedure. Conversely, PID completed one month later does not have this swelling. PID can therefore show great variation, depending on the timing of the analysis. It is hypothesized that PID completed on Day 0 demonstrates lower dosimetric parameters than PID completed one month later. Methods: Thirteen low risk prostate cancer patients, (Stage ≤ T2, PSA < 13.9, Gleason Score ≤7) were implanted with 125Iodine seeds, with a prescription dose of 145Gy to the prostate plus a 5mm margin. Computed Tomography (CT) PID was completed for each patient on day 0 and on average 33 days following the implant. The prostate was contoured on each axial CT image and the data was analyzed using commercially available PSI planning software. The dose which encompassed 90% of the prostate volume (D90) was calculated for day 0 and day 33 PID. Results: On average, the prostate volume contoured was larger on day 0 PID (Avg. 44.9 cc; range 19–97 cc) compared to day 33 PID (Avg. 38.9 cc; range 18–59 cc) (P = 0.068). The D90 values however, were significantly higher on day 33 PID (Avg.163.7 Gy; range 125–212 Gy) than on day 0 PID (Avg.149 Gy; range 112–166 Gy) (P = 0.003). This D90 relationship was even demonstrated paradoxically in two patients whose contoured prostate volume was larger on the day 33 PID as compared to the day 0 PID. Conclusions: Timing does matter in the analysis of post implant dosimetry for PSI brachytherapy. The D90 values were significantly greater on day 33 PID compared to Day 0 PID while the contoured prostate volumes were not. Future studies which use PID planning to evaluate implant quality should specify the timing of the PID, as this would facilitate cross study comparison. No significant financial relationships to disclose.
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Affiliation(s)
- K. J. Minehan
- Mayo Clinic, Rochester, MN; Franciscan Skemp Heathcare/Mayo Health System, LaCrosse, WI
| | - K. Furutani
- Mayo Clinic, Rochester, MN; Franciscan Skemp Heathcare/Mayo Health System, LaCrosse, WI
| | - K. McNamara
- Mayo Clinic, Rochester, MN; Franciscan Skemp Heathcare/Mayo Health System, LaCrosse, WI
| | - D. Groshek
- Mayo Clinic, Rochester, MN; Franciscan Skemp Heathcare/Mayo Health System, LaCrosse, WI
| | - E. Mitchell
- Mayo Clinic, Rochester, MN; Franciscan Skemp Heathcare/Mayo Health System, LaCrosse, WI
| | - M. Price
- Mayo Clinic, Rochester, MN; Franciscan Skemp Heathcare/Mayo Health System, LaCrosse, WI
| | - M. Emme
- Mayo Clinic, Rochester, MN; Franciscan Skemp Heathcare/Mayo Health System, LaCrosse, WI
| | - T. Harms
- Mayo Clinic, Rochester, MN; Franciscan Skemp Heathcare/Mayo Health System, LaCrosse, WI
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Furutani K, Akhtar A, Dahl R, Harms T. Po-Poster - 04: A daily quality assurance measurement for dynamic MLC treatments. Med Phys 2005. [DOI: 10.1118/1.2030983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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50
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Fuwa N, Kodaira T, Furutani K, Tachibana H, Toita K, Shikama N, Kano M, Yuta A, Hayashi N, Onishi H. Excellent treatment results of alternating chemoradiotherapy for nasopharyngeal cancer-A phase II study-. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- N. Fuwa
- Aichi Cancer Ctr, Nagoya, Japan; Ryukyu Univ, Naha, Japan; Sinsyu Univ, Matsumoto, Japan; Fukushima Univ, Fukushima, Japan; Mie Univ, Tsu, Japan; Nagasaki univrsity, Nagasaki, Japan; Ymanashi Univ, Koufu, Japan
| | - T. Kodaira
- Aichi Cancer Ctr, Nagoya, Japan; Ryukyu Univ, Naha, Japan; Sinsyu Univ, Matsumoto, Japan; Fukushima Univ, Fukushima, Japan; Mie Univ, Tsu, Japan; Nagasaki univrsity, Nagasaki, Japan; Ymanashi Univ, Koufu, Japan
| | - K. Furutani
- Aichi Cancer Ctr, Nagoya, Japan; Ryukyu Univ, Naha, Japan; Sinsyu Univ, Matsumoto, Japan; Fukushima Univ, Fukushima, Japan; Mie Univ, Tsu, Japan; Nagasaki univrsity, Nagasaki, Japan; Ymanashi Univ, Koufu, Japan
| | - H. Tachibana
- Aichi Cancer Ctr, Nagoya, Japan; Ryukyu Univ, Naha, Japan; Sinsyu Univ, Matsumoto, Japan; Fukushima Univ, Fukushima, Japan; Mie Univ, Tsu, Japan; Nagasaki univrsity, Nagasaki, Japan; Ymanashi Univ, Koufu, Japan
| | - K. Toita
- Aichi Cancer Ctr, Nagoya, Japan; Ryukyu Univ, Naha, Japan; Sinsyu Univ, Matsumoto, Japan; Fukushima Univ, Fukushima, Japan; Mie Univ, Tsu, Japan; Nagasaki univrsity, Nagasaki, Japan; Ymanashi Univ, Koufu, Japan
| | - N. Shikama
- Aichi Cancer Ctr, Nagoya, Japan; Ryukyu Univ, Naha, Japan; Sinsyu Univ, Matsumoto, Japan; Fukushima Univ, Fukushima, Japan; Mie Univ, Tsu, Japan; Nagasaki univrsity, Nagasaki, Japan; Ymanashi Univ, Koufu, Japan
| | - M. Kano
- Aichi Cancer Ctr, Nagoya, Japan; Ryukyu Univ, Naha, Japan; Sinsyu Univ, Matsumoto, Japan; Fukushima Univ, Fukushima, Japan; Mie Univ, Tsu, Japan; Nagasaki univrsity, Nagasaki, Japan; Ymanashi Univ, Koufu, Japan
| | - A. Yuta
- Aichi Cancer Ctr, Nagoya, Japan; Ryukyu Univ, Naha, Japan; Sinsyu Univ, Matsumoto, Japan; Fukushima Univ, Fukushima, Japan; Mie Univ, Tsu, Japan; Nagasaki univrsity, Nagasaki, Japan; Ymanashi Univ, Koufu, Japan
| | - N. Hayashi
- Aichi Cancer Ctr, Nagoya, Japan; Ryukyu Univ, Naha, Japan; Sinsyu Univ, Matsumoto, Japan; Fukushima Univ, Fukushima, Japan; Mie Univ, Tsu, Japan; Nagasaki univrsity, Nagasaki, Japan; Ymanashi Univ, Koufu, Japan
| | - H. Onishi
- Aichi Cancer Ctr, Nagoya, Japan; Ryukyu Univ, Naha, Japan; Sinsyu Univ, Matsumoto, Japan; Fukushima Univ, Fukushima, Japan; Mie Univ, Tsu, Japan; Nagasaki univrsity, Nagasaki, Japan; Ymanashi Univ, Koufu, Japan
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