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• 2015年

  -

  2019年

  札幌医科大学   大学院医学研究科  

• 2010年

  -

  2016年

  札幌医科大学   医学部   医学科  

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• 2021年08月

  -

  継続中

  札幌医科大学   麻酔科学講座   助教

  MD. PhD.

• 2018年04月

  -

  2020年07月

  北海道立子ども総合医療療育センター   麻酔科学講座   診療医

  MD. PhD.

• 2015年04月

  -

  2018年03月

  札幌医科大学   麻酔科学講座   診療医

  MD

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• ライフサイエンス   麻酔科学  

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• 札幌医科大学   麻酔科学講座   助教   MD. Ph.D  

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• 脳腸相関

• 気道管理

• 小児麻酔

• 麻酔科学

• 脳神経外科麻酔

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• 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年03月  [国際誌]

  　概要を見る

  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年11月  [査読有り]  [国際誌]

  担当区分：   筆頭著者  , 責任著者

  　概要を見る

  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年10月  [査読有り]

  担当区分：   筆頭著者  , 責任著者

  　概要を見る

  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年06月  [査読有り]  [国際誌]

  　概要を見る

  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年06月  [査読有り]  [国内誌]

  　概要を見る

  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 【 表示 ／ 非表示 】

• 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年

  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年

  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年

  J-GLOBAL

受賞 【 表示 ／ 非表示 】

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• 若手奨励賞

  2021年06月   日本麻酔科学会   筋弛緩使用全身麻酔下患者において， i-gel®およびLMA-SupremeTM使用時の頭部回旋位は， 口咽頭リーク圧を低下させる  

  受賞者： 茶木友浩, 立花俊祐, 汲田翔, 佐藤帆奈美, 濱田耕介, 山蔭道明

• 最優秀演題賞

  2017年09月   日本麻酔科学会 北海道・東北支部   プロポフォールの溶媒である脂肪製剤は 酸化ストレスを介して横紋筋障害を引き起こす  

  受賞者： 茶木友浩, 平田直之, 吉川裕介, 川口亮一, 山蔭道明

共同研究・競争的資金等の研究課題 【 表示 ／ 非表示 】

共同研究・競争的資金等の研究課題 【 表示 ／ 非表示 】

• 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)

  研究期間:

  2023年04月

  -

  2026年03月

   

  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)

  研究期間:

  2022年04月

  -

  2025年03月

   

  佐藤 慧, 茶木 友浩

• 幼若脳の麻酔薬神経毒性に対する新たなアプローチ-「脳腸相関」から予防法を探求する

  研究期間:

  2021年04月

  -

  2022年03月

   

  茶木友浩

  担当区分： 研究代表者

• 幼若脳の麻酔薬神経毒性に対する新たなアプローチ-「脳腸相関」から予防法を探求する

  若手研究

  研究期間:

  2020年04月

  -

  2024年03月

   

  茶木 友浩

  　研究概要を見る

  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。

• プロポフォール注入症候群治療戦略の探求-デクスメデトミジンの可能性を探る

  若手研究(B)

  研究期間:

  2017年04月

  -

  2020年03月

   

  茶木 友浩

  　研究概要を見る

  ラットに対して、静脈麻酔薬であるプロポフォールの溶媒である脂肪製剤を3日間持続投与したところ、血液データ上、骨格筋障害を呈することが明らかとなり、プロポフォール注入症候群の臨床兆候の中でも最も特徴的な横紋筋融解、骨格筋障害に焦点をあて、病態の解析を行った。脂肪製剤中に多く含まれる多価不飽和脂肪酸が脂質過酸化反応を介して骨格筋障害を引き起こしていることを明らかにし、抗酸化物質であるαトコフェロールによって骨格筋障害が軽減されることを確認した。デクスメデトミジンによる介入も行ったが、明らかな骨格筋障害軽減効果は認められなかった。