TACHIBANA Syunsuke

写真a

Affiliation

School of Medicine, Department of Anesthesiology

Job title

Assistant Professor
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Education 【 display / non-display 】

  • 2014
    -
    2018

    Sapporo Medical University   Graduate School of Medicine  

  • 2003
    -
    2009

    札幌医科大学   医学部   医学科  

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Research Experience 【 display / non-display 】

  • 2020.04
    -
    Now

    Sapporo Medical University   麻酔科学講座   助教

  • 2014.04
    -
    2018.03

    Sapporo Medical University   麻酔科学講座   診療医

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Research Areas 【 display / non-display 】

  • Life sciences   Anesthesiology   brain function

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Research Interests 【 display / non-display 】

  • brain function

  • 神経麻酔

  • Anesthesia

  • 医工連携

  • 臨床体温管理

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Papers 【 display / non-display 】

  • Venoarterial extracorporeal membrane oxygenation for cardiopulmonary resuscitation: A retrospective study comparing the outcomes of fluoroscopy.

    Soichi Tanaka, Shunsuke Tachibana, Takashi Toyohara, Hajime Sonoda, Michiaki Yamakage

    Heliyon   10 ( 2 ) e24565  2024.01  [International journal]

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    BACKGROUND: Extracorporeal cardiopulmonary resuscitation (ECPR) using venoarterial extracorporeal membrane oxygenation is performed for out-of-hospital cardiac arrest; however, it is associated with a risk of several complications. OBJECTIVE: To investigate whether the fluoroscopy equipment was removed from the emergency department (ED) and whether it would be beneficial to transport the patient to the fluoroscopy room to reduce vascular complications without affecting the induction time. METHODS: This single-center, retrospective, before-and-after analysis was conducted at a tertiary emergency medical center and included 59 patients who underwent ECPR for out-of-hospital cardiac arrest between May 2017 and March 2022. The patients were divided into two groups: those who underwent cannulation in the ED without fluoroscopy (ED-ECPR group) and those who were transferred directly from the ED to the cardiac angiography room (ECPR call group). RESULTS: The rate of vascular complications associated with ECPR was significantly lower in the ECPR group than in the ED-ECPR group (40.6 % [14/32] vs. 10 % [2/20], respectively; p = 0.014). The duration from ED arrival to venoarterial extracorporeal membrane oxygenation initiation was similar in the two groups (median: 23.0 min in the ED-ECPR group vs. 25.5 min in the ECPR call group, p = 0.71). Results adjusted for confounding factors showed that performing ECPR under fluoroscopy was a consistent and independent element of vascular complication rates (adjusted odds ratio: 9.92, 95 % confidence interval: 2.04 to 81.2, p = 0.011). CONCLUSIONS: Fluoroscopy-guided ECPR can significantly reduce the incidence of vascular complications even if the ED and fluoroscopy room are far apart. However, no significant difference was observed in the time required to establish ECPR in the cardiac catheterization laboratories.

    DOI PubMed

  • Comparing leak pressure of LMA® ProSeal™ versus i-gel® at head rotation: a randomized controlled trial.

    Tomohiro Chaki, Masatsugu Koizumi, Shunsuke Tachibana, Tomomi Matsumoto, Tomoe Kumagai, Yuki Hashimoto, Michiaki Yamakage

    Canadian journal of anaesthesia = Journal canadien d'anesthesie    2023.11  [International journal]

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    PURPOSE: The effect of head rotation on supraglottic airway (SGA) oropharyngeal leak pressure (OPLP) has not been well elucidated. The aim of this study was to help clarify which SGA device provides higher OPLP at head-rotated position. METHODS: Patients who underwent elective surgery under general anesthesia were enrolled and randomly divided into laryngeal mask airway (LMA®) ProSeal™ and i-gel® groups. The allocated SGA device was inserted under anesthesia. The primary outcome was OPLP, and secondary outcomes were ventilation score, expiratory tidal volume, and maximum pressure under volume-controlled ventilation (VCV) with an inspiratory tidal volume of 10 mL·kg-1 ideal body weight and fibreoptic view of the vocal cords at 0°, 30°, and 60° head rotation. RESULTS: Data from 78 and 76 patients were analyzed in the LMA ProSeal and i-gel groups, respectively. The mean (standard deviation) OPLP of the LMA ProSeal was significantly higher than that of the i-gel at the 60° head-rotated position (LMA ProSeal, 20.4 [6.5] vs i-gel, 16.9 [7.8] cm H2O; difference in means, 3.6; adjusted 95% confidence interval, 0.5 to 6.6; adjusted P = 0.02, adjusted for six comparisons). The maximum pressure under VCV at 60° head rotation was significantly higher in the LMA ProSeal group than in the i-gel group. The expiratory tidal volume of the LMA ProSeal did not significantly change with head rotation and was significantly higher than that of the i-gel at 60° head rotation. Ventilation score, fibreoptic view of the vocal cords, and complications were not significantly different between the ProSeal and i-gel groups. CONCLUSIONS: The LMA ProSeal provides higher OPLP than the i-gel at a 60° head-rotated position under general anesthesia. TRIAL REGISTRATION: Japan Registry of Clinical Trials (https://jrct.niph.go.jp) (JRCT1012210043); registered 18 October 2021.

    DOI PubMed

  • I-gel Plus acts as a superior conduit for fiberoptic intubation than standard i-gel

    Tomohiro Chaki, Shunsuke Tachibana, Sho Kumita, Satoshi Sato, Tomoki Hirahata, Yuta Ikeshima, Yuki Ohsaki, Michiaki Yamakage

    Scientific Reports ( Springer Science and Business Media LLC )  13 ( 1 )  2023.10

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    Abstract The supraglottic airway (SGA) is widely used. I-gel Plus is a next-generation i-gel with some improvements, including facilitation of fiberoptic tracheal intubation (FOI). To compare the performance of i-gel Plus and standard i-gel as conduits for FOI, a Thiel-embalmed cadaveric study was conducted. Twenty-two anesthesiologists were enrolled as operators in Experiment 1. The i-gel Plus and standard i-gel were inserted into one cadaver, and the FOI was performed through each SGA. The primary outcome was time required for FOI. The secondary outcomes were the number of attempts and visual analog scale (VAS) score for difficulty in FOI. Moreover, fiberoptic views of the vocal cords in each SGA were assessed by an attending anesthesiologist using nine cadavers in Experiment 2. The percentage of glottic opening (POGO) score without fiberscope tip upward flexion and upward angle of the fiberscope tip to obtain a 100% POGO score were evaluated as secondary outcomes. The time for FOI through i-gel Plus was significantly shorter than that through standard i-gel (median (IQR), i-gel Plus: 30.3 (25.4–39.0) s, vs standard i-gel: 54.7 (29.6–135.0) s; median of differences, 24.4 s; adjusted 95% confidence interval, 3.0–105.7; adjusted P = 0.040). Although the number of attempts for successful FOI was not significantly different, the VAS score for difficulty in the i-gel Plus group was significantly lower (easier) than that in the standard i-gel group. Moreover, i-gel Plus required a significantly smaller upward angle of the fiberscope tip to obtain a 100% POGO score. FOI can be performed more easily using i-gel Plus than using standard i-gel because of the improved fiberoptic visibility of vocal cords.

    DOI

  • Cricothyrotomy for an Unexpected Cannot Intubate, Cannot Ventilate Situation for a Patient with Chronic Graft-Versus-Host Disease After Induction of General Anesthesia: A Case Report.

    Soichi Tanaka, Shunsuke Tachibana, Keito Kusakabe, Keiko Wakasugi, Hajime Sonoda, Michiaki Yamakage

    The American journal of case reports   24   e938992  2023.02  [International journal]

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    BACKGROUND Chronic graft-versus-host disease (GVHD) is a major complication of hematopoietic stem cell transplantations. Due to fibrotic changes, patients with GVHD are at risk for difficult airway management. We encountered a case of chronic GVHD that went into a "cannot intubate, cannot ventilate" (CICV) condition after induction of general anesthesia and was managed using cricothyrotomy. CASE REPORT A 45-year-old man with uncontrolled chronic GVHD developed pneumothorax of the right lung. Thoracoscopic dissection of the adhesions, closure of the pneumostomy, and drainage under general anesthesia were planned. In the preoperative airway assessment, we concluded that using a video laryngoscope or endotracheal fiber would be sufficient to intubate the patient after sedation and that airway management after the loss of consciousness would not be difficult. Therefore, general anesthesia was induced by rapid induction; however, the patient developed difficult mask ventilation. Intubation was attempted via a video laryngoscope or bronchofiber but failed. Ventilating using a supraglottic instrument was difficult. The patient was evaluated to have a CICV condition. Thereafter, because of a rapid decrease in oxygen saturation (SpO2) and bradycardia, a cricothyrotomy was performed. Subsequently, ventilation became adequate, SpO2 increased immediately and drastically, and respiration and circulatory dynamics recovered. CONCLUSIONS We believe that anesthesiologists should practice, prepare, and simulate airway emergencies that can be experienced during surgery. In this case, we recognized that skin sclerosis in the neck and chest could lead to CICV. It may be suitable for airway management of scleroderma-like patients to select conscious intubation with a bronchoscope as a first choice.

    DOI PubMed

  • Correction to: The intraoperative motor-evoked potential when propofol was changed to remimazolam during general anesthesia: a case series.

    Shoto Yamada, Yukinori Akiyama, Shunsuke Tachibana, Kengo Hayamizu, Yusuke Kimura, Shuichi Hashimoto, Michiaki Yamakage, Nobuhiro Mikuni

    Journal of anesthesia   37 ( 1 ) 160 - 160  2023.02  [Domestic journal]

    DOI PubMed

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Books and Other Publications 【 display / non-display 】

  • 神経麻酔最前線 : すべては患者の機能維持・向上のために

    澤田, 敦史, 立花, 俊祐, 茶木, 友浩, 山蔭, 道明

    中外医学社  2021.06 ISBN: 9784498055483

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Misc 【 display / non-display 】

  • 【最新主要文献とガイドラインでみる 麻酔科学レビュー 2023】Awake craniotomyの麻酔

    立花 俊祐

    麻酔科学レビュー ( (株)総合医学社 )  2023   247 - 252  2023.05

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    ＜最近の動向＞●Awake craniotomyの現状や傾向を把握するためには,多施設を対象とした大規模調査が必要である.日本国内だけでなく,国際的な多施設研究がいくつか実施されており,結果を集約することで最近の動向を知ることができた.●Awake craniotomyの麻酔管理としてmonitored anesthesia care(MAC)法が注目されており,AAA法に比べてMAC法がよりよいのではないかという論調を複数確認することができた.新型コロナウイルス流行の昨今,気道確保手技による飛沫やエアロゾルを減らすためのシフトという意味からも,理に適った動向といえるだろう.●グリオーマ以外でも,awake craniotomyの適応や予後についての大規模な検証論文が散見された.(著者抄録)

  • Awake craniotomyの麻酔を上手に行うために Awake craniotomyの麻酔を再考する 洗練された麻酔を目指して

    立花 俊祐

    日本臨床麻酔学会誌 ( 日本臨床麻酔学会 )  43 ( 1 ) 48 - 52  2023.01

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    Awake craniotomyの麻酔管理を行う上で,「すみやかで安定した入眠と覚醒」や「手術中,とくに覚醒期において生じうる痛みや合併症の予防」を提供することが重要である.日本における他施設と同様にわれわれの施設でも,Awake craniotomyの管理は,プロポフォールを主軸とした静脈麻酔と頭部神経ブロックを併用したAsleep-Awake-Asleep(AAA)法で麻酔を完遂している.当施設では過去に12～84歳の患者の麻酔を経験したが,それぞれの背景因子は多様で,周術期管理について改善すべき点がある.小児や高齢者など年齢に基づいた管理の層別化を図るだけではなく,Awake craniotomyの完遂を妨げうる因子を事前に把握し,それらのリスク因子を意識した管理を行うことも洗練された麻酔を目指すために必要である.(著者抄録)

  • 持続硬膜外鎮痛が困難な開胸胸壁再建手術に対し,モルヒネ硬膜外単回投与を含む多角的鎮痛で術後痛を管理した2症例

    新田 麻子, 立花 俊祐, 茶木 友浩, 山蔭 道明

    日本臨床麻酔学会誌 ( 日本臨床麻酔学会 )  43 ( 1 ) 25 - 30  2023.01

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    開胸術では,術後の重度の疼痛や呼吸器合併症,慢性痛への移行リスクなどを考慮し,硬膜外麻酔を含む区域麻酔による持続的鎮痛が推奨されている.しかし広背筋皮弁による胸壁再建を伴う場合,解剖学的位置により胸部硬膜外カテーテル留置は困難である.広背筋皮弁による胸壁再建術に対しモルヒネの胸部硬膜外単回投与を含めた多角的鎮痛を行った.1例目は,術直後よりNRS(numerical rating scale) 0～2と疼痛の訴えは少なかった.2例目は術直後のNRSは4～6であったが,術後2日目にはNRS 2に改善した.2症例とも慢性痛への移行はなく経過した.また,オピオイドによる重大な有害事象は生じなかった.(著者抄録)

  • 術前診察では予期できなかった気道確保困難に対してMcGRATH MAC併用の気管支ファイバースコープガイド下挿管が有用であった1症例

    小北 篤史, 立花 俊祐, 茶木 友浩, 枝長 充隆, 山蔭 道明

    麻酔 ( 克誠堂出版(株) )  71 ( 11 ) 1196 - 1200  2022.11

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    術前気道評価では困難気道を予測する所見を認めず,気道確保は容易と判断したが,麻酔導入時に気管挿管が非常に困難な症例を経験した。最終的にMcGRATH MAC(コヴィディエンジャパン,東京)による喉頭展開下に気管支ファイバースコープガイド下経口挿管を施行した。予期せぬ気道確保困難に遭遇する可能性があるため,日ごろから,さまざまな気道管理法に精通する必要がある。(著者抄録)

  • 新たなワイヤレス体温測定装置Moni-Patchは麻酔中の深部体温を正確に測定する

    西原 教晃, 立花 俊祐, 山蔭 道明

    日本臨床麻酔学会誌 ( 日本臨床麻酔学会 )  42 ( 6 ) S213 - S213  2022.10

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Research Projects 【 display / non-display 】

  • How to reduce anesthesia and surgical invasions in the frail brain - Strategies via gut microbiota regulation

    Grant-in-Aid for Scientific Research (C)

    Project Year :

    2022.04
    -
    2025.03
     

    立花 俊祐

  • Elucidation of the link between the environmental change in the intestinal flora and cognitive decline due to anesthetic surgery

    Grant-in-Aid for Early-Career Scientists

    Project Year :

    2019.04
    -
    2022.03
     

    Tachibana Shunsuke

    　View Summary

    The primary objective of this study was to elucidate the mechanisms and effects on cognitive function mediated by intestinal flora during the perioperative period. Using a group of mice that were assumed to be in the perioperative period, we analyzed the variation in intestinal flora diversity. The RNA was converted to cDNA and then analyzed individually by qRT-PCR with reference to candidate genes selected by transcriptome analysis in our previous study. Surgical and/or anesthetic invasions on older mice may affect changes in RNA expression in the brain.

  • Prevention strategies for perioperative neuroinflammation related diseases with a focus on stabilization of intestinal microbiota

    Grant-in-Aid for Scientific Research (C)

    Project Year :

    2019.04
    -
    2022.03
     

    Yamakage Michiaki

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    In a metagenomic analysis of cecal contents collected under anesthesia after surgical intervention, we were unable to explore significant changes between the groups. It was suggested that the timeline of intervention and other factors need to be re-examined. While the composition of the cecal contents was not acutely altered, we did find changes in delirium behavior in the surgical group, with no significant differences between groups. Additional experiments are planned.
    Translated with www.DeepL.com/Translator (free version)

  • Analysis of a relationship between postoperative delirium or/and cognitive dysfunction and aging by transcriptome analysis

    Grant-in-Aid for Scientific Research (C)

    Project Year :

    2016.04
    -
    2019.03
     

    Yamakage Michiaki, TACHIBANA SHUNSUKE

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    Transcriptome analysis revealed that age differences resulted in significant changes in gene expression in the hippocampus after anesthesia and surgery. In other words, it was suggested that metabolisms and reactivities in the brain cause differences in responses due to aging. In addition, the sensitivity of anesthetics due to aging and the immune response to surgical insult are different, and the possibility of clarifying the mechanism of influences and differences in brain function was shown.

  • Elucidation of the mechanism of postoperative cognitive dysfunction through epigenetics

    Grant-in-Aid for Young Scientists (B)

    Project Year :

    2015.04
    -
    2019.03
     

    Tachibana Shunsuke

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    We performed transcriptomic analysis and comprehensively analyzed the expression changes of messenger RNA (mRNA) in the brain, especially in the hippocampus due to surgery and anesthesia stress. Furthermore, we identified the all expression genes that increased or decreased by surgery and anesthesia stress, and also found that the expression of a specific gene changes in conjunction with the deterioration of cognitive function examined in the Burns Maze test. In this study, we were able to elucidate a part of the mechanism of post oeprative cognitive dysfunction (POCD), and clarify the specify mRNA as a marker that could predict the onset of cognitive dysfunction. And, we believe that the information provided from this research will bring significant meaning to future research.

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