Education 【 display / non-display 】

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  

Research Experience 【 display / non-display 】

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

Professional Memberships 【 display / non-display 】

Professional Memberships 【 display / non-display 】

• 　

  　

  　

  気道管理学会

• 　

  　

  　

  Japanese Society for Neuroscience in Anesthesiology and Critical Care

• 　

  　

  　

  日本 Awake Surgery学会

• 　

  　

  　

  日本麻酔科学会

Research Areas 【 display / non-display 】

Research Areas 【 display / non-display 】

• Life sciences   Anesthesiology   brain function

Research Interests 【 display / non-display 】

Research Interests 【 display / non-display 】

• brain function

• 神経麻酔

• Anesthesia

• 臨床体温管理

• 医工連携

Papers 【 display / non-display 】

Papers 【 display / non-display 】

• Gut Microbiota Influences Developmental Anesthetic Neurotoxicity in Neonatal Rats.

  Tomohiro Chaki, Yuri Horiguchi, Shunsuke Tachibana, Satoshi Sato, Tomoki Hirahata, Noriaki Nishihara, Natsumi Kii, Yusuke Yoshikawa, Kengo Hayamizu, Michiaki Yamakage

  Anesthesia and analgesia    2025.02  [International journal]

  　View Summary

  BACKGROUND: Anesthetic exposure during childhood is significantly associated with impairment of neurodevelopmental outcomes; however, the causal relationship and detailed mechanism of developmental anesthetic neurotoxicity remain unclear. Gut microbiota produces various metabolites and influences the brain function and development of the host. This relationship is referred to as the gut-brain axis. Gut microbiota may influence developmental anesthetic neurotoxicity caused by sevoflurane exposure. This study investigated the effect of changes in the composition of gut microbiota after fecal microbiota transplantation on spatial learning disability caused by developmental anesthetic neurotoxicity in neonatal rats. METHODS: Neonatal rats were allocated into the Control (n = 10) and Sevo (n = 10) groups in Experiment 1 and the Sevo (n = 20) and Sevo+FMT (n = 20) groups in Experiment 2, according to the randomly allocated mothers' group. The rats in Sevo and Sevo+FMT groups were exposed to 2.1% sevoflurane for 2 hours on postnatal days 7 to 13. Neonatal rats in the Sevo+FMT group received fecal microbiota transplantation immediately after sevoflurane exposure on postnatal days 7 to 13. The samples for fecal microbiota transplantation were obtained from nonanesthetized healthy adult rats. Behavioral tests, including Open field, Y-maze, Morris water maze, and reversal Morris water maze tests, were performed to evaluate spatial learning ability on postnatal days 26 to 39. RESULTS: Experiment 1 revealed that sevoflurane exposure significantly altered the gut microbiota composition. The relative abundance of Roseburia (effect value: 1.01) and Bacteroides genus (effect value: 1.03) increased significantly after sevoflurane exposure, whereas that of Lactobacillus (effect value: -1.20) decreased significantly. Experiment 2 revealed that fecal microbiota transplantation improved latency to target (mean ± SEM; Sevo group: 9.7 ± 8.2 seconds vs, Sevo+FMT group: 2.7 ± 2.4 seconds, d=1.16, 95% confidence interval: -12.7 to -1.3 seconds, P = .019) and target zone crossing times (Sevo group: 2.4 ± 1.6 vs, Sevo+FMT group: 5.4 ± 1.4, d=1.99, 95% confidence interval: 2.0-5.0, P < .001) in the reversal Morris water maze test. Microbiota analysis revealed that the α-diversity of gut microbiota increased after fecal microbiota transplantation. Similarly, the relative abundance of the Firmicutes phylum (effect value: 1.44), Ruminococcus genus (effect value: 1.69), and butyrate-producing bacteria increased after fecal microbiota transplantation. Furthermore, fecal microbiota transplantation increased the fecal concentration of butyrate and induced histone acetylation and the mRNA expression of brain-derived neurotrophic factor in the hippocampus, thereby suppressing neuroinflammation and neuronal apoptosis. CONCLUSIONS: The alternation of gut microbiota after fecal microbiota transplantation influenced spatial learning ability in neonatal rats with developmental anesthetic neurotoxicity. Modulation of the gut microbiota may be an effective prophylaxis for developmental anesthetic neurotoxicity in children.

  DOI PubMed

• INJEX50 could improve the success rate of local anesthesia for arterial cannulation in the pediatric intensive care unit: A randomized, double-blind, single-center study.

  Wataru Sakai, Tomohiro Chaki, Shunsuke Tachibana, Yuki Ichisaka, Yuko Nawa, Tomohiro Nawa, Michiaki Yamakage

  Paediatric anaesthesia    2024.05  [International journal]

  　View Summary

  BACKGROUND: Quick arterial cannulation is required in pediatric emergency situation, which require effective local anesthesia to avoid withdrawal movement. However, pediatric local anesthesia could be difficult because of withdrawal movement. Jet injectors, which are needleless and provide local anesthesia quickly, could be helpful for pediatric local anesthesia during arterial cannulation. AIMS: This study aimed to examine whether new jet injector "INJEX50" could improve the success rate of local anesthesia for arterial cannulation in pediatric intensive care unit compared with the current standard of care, infiltration using a 26-gauge needle. METHODS: This study was a randomized, double-blind, single-center study. Participants were infants and young children in the pediatric intensive care unit, who required an arterial line. Local anesthesia was performed with either a 26-gauge needle (group C) or INJEX50 (group I) before arterial cannulation. The primary outcome (success of local anesthesia) was the presence of withdrawal movement at the time of skin puncture for arterial cannulation. The secondary outcomes included rescue sedation during arterial cannulation. Data were analyzed using Fisher's exact test and the Mann-Whitney U-test, with values of p < .05 considered statistically significant. RESULTS: Seventy patients were randomly assigned to groups C and I. The local anesthesia success rate in group I (30/35 [86%]) was significantly higher than that in group C (15/35 [43%], odds ratio, 8.00; 95% confidence interval, 2.51-25.5; p = .0005). In conclusion, INJEX50 could improve success rate of local anesthesia for arterial cannulation in pediatric intensive care unit compared with 26-gauge needle.

  DOI PubMed

• 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]

  　View Summary

  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]

  　View Summary

  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

  　View Summary

  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

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Books and Other Publications 【 display / non-display 】

Books and Other Publications 【 display / non-display 】

• 気道管理大全 : Evidence and Tips

  山蔭, 道明, 立花, 俊祐, 茶木, 友浩

  中外医学社  2024.06 ISBN: 9784498055568

• 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

Misc 【 display / non-display 】

Misc 【 display / non-display 】

• 研究者の最新動向 フレイル脳への麻酔・手術侵襲を減弱するには 腸内細菌叢制御を介した戦略

  立花 俊祐

  Precision Medicine ( (株)北隆館 )  8 ( 1 ) 47 - 48  2025.01

  　View Summary

  われわれは,フレイル患者を想定した麻酔管理に関する基礎研究を推進している。術後せん妄は,コグニティブフレイルのひとつの現症であると考えており,また術後の筋力低下は身体的フレイルの根幹であるため,周術期管理を担う際にこれらの因子は解決すべき問題である。周術期におけるコンパクトな介入がフレイル症状を緩和し,患者予後を改善することができれば理想的であるだろうという理念に基づいて,複数の実験系を遂行している。本稿では,"臨床的な実現性を意識した"老化促進マウスに対する麻酔・手術侵襲前段階での介入について紹介する。(著者抄録)

• 【最新主要文献とガイドラインでみる 麻酔科学レビュー 2024】Awake craniotomyの麻酔

  立花俊祐

  麻酔科学レビュー   2024  2024.05

  J-GLOBAL

• 周術期の高体温 まとめ たかが体温と侮るなかれ,刮目して論ぜよ

  立花俊祐

  Lisa   31 ( 7 )  2024

  J-GLOBAL

• 脳脊髄液減少症に対して,三度にわたる腹臥位X線透視下ブラッドパッチにより症状が改善した一症例

  枝長充隆, 諸原清香, 濱田耕介, 小松克也, 立花俊祐, 山蔭道明

  日本呼吸療法医学会学術集会プログラム・抄録集   46th (Web)  2024

  J-GLOBAL

• 症例ライブラリー 周術期の低体温 まとめ たかが体温と侮るなかれ,刮目して見よ

  立花 俊祐

  LiSA ( (株)メディカル・サイエンス・インターナショナル )  30 ( 12 ) 1286 - 1287  2023.12

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Research Projects 【 display / non-display 】

Research Projects 【 display / non-display 】

• Establishment of a strategy to prevent postoperative delirium with the stability of the intestinal microbiota

  Grant-in-Aid for Scientific Research (C)

  Project Year :

  2024.04

  -

  2027.03

   

  西原 教晃, 立花 俊祐

• 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

  　View Summary

  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

  　View Summary

  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.

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