Education 【 display / non-display 】

Education 【 display / non-display 】

• 2015

  -

  2019

  Sapporo Medical University   Graduate School of Medicine  

• 2010

  -

  2016

  Sapporo Medical University   医学部   医学科  

Research Experience 【 display / non-display 】

Research Experience 【 display / non-display 】

• 2021.08

  -

  Now

  Sapporo Medical University   Department of anesthesiology   Assistant professor

  MD. PhD.

• 2018.04

  -

  2020.07

  Hokkaido Medical Center for Child Health and Rehabilitation   Department of anesthesiology   診療医

  MD. PhD.

• 2015.04

  -

  2018.03

  Sapporo Medical University   Department of anesthesiology   Doctor

  MD

Research Areas 【 display / non-display 】

Research Areas 【 display / non-display 】

• Life sciences   Anesthesiology  

Affiliation 【 display / non-display 】

Affiliation 【 display / non-display 】

• Sapporo Medical University   Department of anesthesiology   Assistant professor   MD. Ph.D  

Research Interests 【 display / non-display 】

Research Interests 【 display / non-display 】

• gut-brain axis

• Airway management

• Pediatric anesthesia

• Anesthesiology

• Neurosurgical anesthesia

Papers 【 display / non-display 】

Papers 【 display / non-display 】

• Comparison of the negative effect of remimazolam and propofol on cardiac contractility: Analysis of a randomised parallel-group trial and a preclinical ex vivo study.

  Yusuke Yoshikawa, Shunsuke Oura, Masatoshi Kanda, Tomohiro Chaki, Naoyuki Hirata, Mitsutaka Edanaga, Michiaki Yamakage

  Clinical and experimental pharmacology & physiology   51 ( 3 ) e13840  2024.03  [International journal]

  　View Summary

  Remimazolam is a newly developed ultra-short-acting benzodiazepine that exerts sedative effects. This study aimed to clarify the effects of remimazolam on cardiac contractility. In a randomised-parallel group trial, haemodynamic parameters were compared between propofol (n = 11) and remimazolam (n = 12) groups during the induction of general anaesthesia in patients undergoing non-cardiac surgery. In a preclinical study, the direct effects of remimazolam on cardiac contractility were also evaluated using isolated rat hearts. RNA sequence data obtained from rat and human hearts were analysed to assess the expression patterns of the cardiac γ-aminobutyric acid type A (GABAA ) receptor subunits. In a clinical study, the proportional change of the maximum rate of arterial pressure rise was milder during the study period in the remimazolam group (propofol: -52.6 [10.2] (mean [standard deviation])% vs. remimazolam: -39.7% [10.5%], p = 0.007). In a preclinical study, remimazolam did not exert a negative effect on left ventricle developed pressure, whereas propofol did exert a negative effect after bolus administration of a high dose (propofol: -26.9% [3.5%] vs. remimazolam: -1.1 [6.9%], p < 0.001). Analysis of the RNA sequence revealed a lack of γ subunits, which are part of the major benzodiazepine binding site of the GABAA receptor, in rat and human hearts. These results indicate that remimazolam does not have a direct negative effect on cardiac contractility, which might contribute to its milder effect on cardiac contractility during the induction of general anaesthesia. The expression patterns of cardiac GABAA receptor subunits might be associated with the unique pharmacokinetics of benzodiazepines in the heart.

  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  [Refereed]  [International journal]

  Authorship：   Lead author  , Corresponding author

  　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  [Refereed]

  Authorship：   Lead author  , Corresponding author

  　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

• A case of safe airway management by fiber-optic nasotracheal intubation in general anesthesia in a pediatric patient with Hajdu-Cheney syndrome: a case report.

  Atsushi Kokita, Tomohiro Chaki, Michiaki Yamakage

  JA clinical reports   9 ( 1 ) 33 - 33  2023.06  [Refereed]  [International journal]

  　View Summary

  BACKGROUND: Hajdu-Cheney syndrome (HCS) is an extremely rare disorder characterized by progressive acro-osteolysis. A unique facial structure and deformity of the cervical spine are associated with a difficult airway. Although several reports describe general anesthesia with orotracheal intubation for patients with HCS, there have been no reports of nasotracheal intubation with a risk of skull base fracture. We describe nasotracheal intubation for oral surgery in a patient with HCS. CASE PRESENTATION: A 13-year-old girl with HCS was scheduled for dental surgery. Preoperative computed tomography revealed no abnormalities including fractures in the skull base or cervical spine. After confirming a lack of vocal cord paralysis by bronchofiberscopic inspection from the nose, general anesthesia was induced with sevoflurane, remifentanil, and rocuronium. Fiber-optic nasotracheal intubation was successfully performed without complications such as depletion of oxygen saturation and massive epistaxis, and the surgery was completed uneventfully. She was discharged the day after surgery with no anesthesia-related complications. CONCLUSIONS: We were able to safely manage the airway of a patient with HCS by nasotracheal intubation under general anesthesia.

  DOI PubMed

• Head cooling wrap could suppress the elevation of core temperature after cardiac surgery during forced-air warming in a pediatric intensive care unit: a randomized clinical trial.

  Wataru Sakai, Tomohiro Chaki, Yuko Nawa, Takayoshi Oyasu, Yuki Ichisaka, Tomohiro Nawa, Hidetsugu Asai, Noriyoshi Ebuoka, Junichi Oba, Michiaki Yamakage

  Journal of anesthesia    2023.06  [Refereed]  [Domestic journal]

  　View Summary

  PURPOSE: The main aim of the current trial was to explore our hypothesis that cooling head wraps lower the core temperature more effectively than ice packs on the head during forced-air warming after pediatric cardiac surgeries. METHODS: This study was a single-center Randomized Controlled Trial. Participants were children with a weight ≤ 10 kg and hyperthermia during forced-air warming after cardiac surgeries. When the core temperature reached 37.5 °C, ice packs on the head (group C) or a cooling head wrap (group H) were used as cooling devices to decrease the core temperature. The primary outcome was the core temperature. The secondary outcomes were the foot surface temperature and heart rate. We measured all outcomes every 30 min for 240 min after the patient developed hyperthermia. We conducted two-way ANOVA as a pre-planned analysis and also the Bonferroni test as a post hoc analysis. RESULTS: Twenty patients were randomly assigned to groups C and H. The series of core temperatures in group H were significantly lower than those in group C (p < 0.0001), and post hoc analysis showed that there was no significant difference in core temperatures at T0 between the two groups and statistically significant differences in all core temperatures at T30-240 between the two groups. There was no difference between the two groups' surface temperatures and heart rates. CONCLUSIONS: Compared to ice packs on the head, head cooling wraps more effectively suppress core temperature elevation during forced-air warming after pediatric cardiac surgery.

  DOI PubMed

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Misc 【 display / non-display 】

Misc 【 display / non-display 】

• 限局性の下行大動脈解離が生じたバルーン大動脈弁形成術(BAV)の1症例

  佐藤慧, 吉川裕介, 茶木友浩, 枝長充隆, 山蔭道明

  Cardiovascular Anesthesia   21 ( Suppl )  2017

  J-GLOBAL

• 超高齢者における経カテーテル大動脈弁植え込み術の一症例

  前田真岐志, 枝長充隆, 茶木友浩, 立花俊祐, 吉川裕介, 山蔭道明

  Cardiovascular Anesthesia   20 ( Suppl )  2016

  J-GLOBAL

• デクスメデトミジンは高血圧性肥大心筋においても直接心筋保護作用を保持する

  吉川裕介, 平田直之, 川口亮一, 宮下龍, 丸山大介, 茶木友浩, 山蔭道明

  Cardiovascular Anesthesia   19 ( Suppl )  2015

  J-GLOBAL

Awards 【 display / non-display 】

Awards 【 display / non-display 】

• Young encouragement award

  2021.06   Japanese Society of Anesthesiologists   Head Rotation Reduces Oropharyngeal Leak Pressure of the i-gel® and LMA-SupremeTM in Paralyzed, Anesthetized Patients, A Randomized Trial

  Winner： Tomohiro Chaki, Shunsuke Tachibana, Sho Kumita, Honami Sato, Kosuke Hamada, Michiaki Yamakage

• Best presentation award

  2017.09   Japanese Society of Anesthesiologists, Hokkaido and Tohoku   Lipid, A Solvent of Propofol, Induces Muscle Wasting via Oxidative Stress

  Winner： Tomohiro Chaki, Naoyuki Hirata, Yusuke Yoshikawa, Ryoichi Kawaguchi, Michiaki Yamakage

Research Projects 【 display / non-display 】

Research Projects 【 display / non-display 】

• 低親和性神経成長因子受容体選択的リガンド：LM11A-31による術後認知機能障害予防戦略

  基盤研究(C)

  Project Year :

  2023.04

  -

  2026.03

   

  山蔭 道明, 平畑 知輝, 茶木 友浩, 佐藤 慧

• トランスポーター機能の修飾を介した麻酔薬の胎盤移行性制御の探究

  基盤研究(C)

  Project Year :

  2022.04

  -

  2025.03

   

  佐藤 慧, 茶木 友浩

• Exploration of the prophylaxis for anesthetic-induced neurodegeneration with gut-brain axis approach in neonate

  Project Year :

  2021.04

  -

  2022.03

   

  Tomohiro Chaki

  Authorship： Principal investigator

• The influence of microbiota to neurotoxicity of general anesthesia for developing brain

  Grant-in-Aid for Early-Career Scientists

  Project Year :

  2020.04

  -

  2024.03

   

  茶木 友浩

  　View Summary

  腸内細菌叢移植による幼若脳麻酔薬神経毒性への影響を明らかにするため、セボフルラン曝露のみを行う（Sevo）群、セボフルラン曝露+腸内細菌叢移植を行う（Sevo+FMT）群にラットを割り付けた。生後28日から施行したモーリス水迷路試験およびY字迷路試験の結果、Sevo+FMT群では空間学習能力が改善する結果を認め、腸内細菌叢移植によって幼若脳麻酔薬神経毒性が軽減される可能性が示唆された。さらに、腸内細菌叢移植による実際の腸内細菌叢の変化を検証するため、生後21日のラットから糞便を採取し、16sリボソーマルRNA解析による腸内細菌叢解析を実施した。その結果、Sevo+FMT群では、Chao1 index及びSimpson indexが有意に高く、さらに門レベルでの解析では、Firmicutes門及びLentisphaerae門の細菌が増加する一方、Bacteroides門及びProteobacteria門の細菌が減少することが明らかとなった。Firmicutes門には、脳内でBDNF産生を促進する短鎖脂肪酸を産生する菌株が多く属していることが知られており、Firmicutes門の細菌増加が行動学的な学習能力改善効果をもたらしたと考えられる。今後は、短鎖脂肪酸の評価および、海馬におけるBDNF産生量、ヒストンアセチル化定量などを行い、腸内細菌叢移植が学習能力改善をもたらした機序について明らかにしていく予定である。

• The mechanism of propofol infusion syndrome - the potency of dexmedetomidine as a treatment or prevention of propofol infusion syndrome

  Grant-in-Aid for Young Scientists (B)

  Project Year :

  2017.04

  -

  2020.03

   

  Chaki Tomohiro

  　View Summary

  We used rats and infused 1% propofol and it's solvent, lipofundin for three days. The rats received propofol infusion did not express the symptoms of propofol infusion syndrome, but the rats received lipofundin expressed the elevation of creatine kinase and myoglobin indicating skeletal muscle damage. We detected that lipid peroxidation related the lipid induced skeletal muscle damage. This mechanism was validated by the phenomenon that the alpha-tocopherol, which is one of the vitamin E, suppressed the lipid induced skeletal muscle damage. We concluded that the lipid which was used as a solvent of propofol induced skeletal muscle damage via lipid peroxidation and propofol itself prevented the skeletal muscle damage by it's anti-oxidative effect. Moreover, we investigated the preventive effect of dexmedetomidine on lipid induced skeletal muscle damage, but dexmedetomidine did not have the attenuating effect of skeletal muscle damage.