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  札幌医科大学附属病院  

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  札幌医科大学附属病院  

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  JA北海道 帯広厚生病院  

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• 札幌医科大学   医学部 麻酔科学講座  

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• 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年02月  [国際誌]

  　概要を見る

  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

• 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

  　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

• Anesthetic management of tracheal stent extraction using a double gum elastic bougie technique

  Satoshi Sato, Tomohiro Chaki, Takayuki Onaka, Michiaki Yamakage

  JA Clinical Reports ( Springer Science and Business Media LLC )  8 ( 1 ) 9 - 9  2022年12月  [国際誌]

  担当区分：   筆頭著者  , 最終著者  , 責任著者

  　概要を見る

  Abstract Background Tracheal stenosis is a life-threatening condition, and management of a patient with a risk of tracheal stenosis is challenging for anesthesiologists. In this report, we describe a method for airway management using two gum elastic bougie method when removing a tracheal stent via a tracheostomy orifice with a risk of airway restenosis. Case presentation A 71-year-old man had an enlarged squamous cell carcinoma of the lung invading the upper mediastinum that had caused severe stenosis of the trachea. Two months after diagnosis, a tracheal stent had been placed to maintain tracheal patency. One month after stent placement, acute respiratory failure was induced by upper airway obstruction caused by subglottic airway edema due to mechanical stimulation of the cranial end of the stent, and the patient was rescued by oral tracheal intubation. Tracheal stent extraction was scheduled to relieve the laryngeal edema. Since there was a risk of tracheal restenosis because of the possibility of accidental evulsion of the orally tracheal tube which intubated to secure an emergency airway and tracheal stent extraction, two gum elastic bougies were inserted through the oral tracheal tube and tracheostomy orifice to facilitate re-intubation. After extraction of the tracheal stent, airway openness was maintained and tracheostomy was completed without any complication. Conclusion Successful management of tracheal stent extraction was performed using a double gum elastic bougie technique.

  DOI PubMed

• 吸入麻酔薬が脳循環生理に与える影響

  佐藤 慧, 枝長 充隆, 茶木 友浩, 山蔭 道明

  臨床麻酔   46 ( 6 ) 815 - 821  2022年06月

  担当区分：   筆頭著者  , 最終著者  , 責任著者

• 新規ベンゾジアゼピン系薬レミマゾラム及びその代謝物の血漿中濃度同時測定法

  村岡 愛, 市川 凌史, 青山 剛, 佐藤 慧, 茶木 友浩, 立花 俊祐, 山蔭 道明, 戸田 貴大

  日本薬学会年会要旨集 ( (公社)日本薬学会 )  142年会   26PO4 - 01S  2022年03月

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• 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

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• 喉頭異物による挿管困難症例への耳鼻科生検把持鉗子を活用した気管挿管介助の工夫

  佐藤 慧, 根符 勇二, 阿部 花菜美, 渡辺 政徳, 田中 悟, 山蔭 道明

  第52回日本集中治療医学会学術集会  

  発表年月： 2025年03月

  開催年月日：

  2025年03月

  　

  　

• Careful medical interviews and echography enabled detection of acute kidney injury and hematoma after lumbar trigger point injection - a case report

  Satoshi Sato, Takahiro Ichimiya, Madoka Ogasawara, Kayoko Okazaki, Akihito Tampo, Hitoshi Namba, Shunsuke Tachibana, Michiaki Yamakage

  American Society of Anesthesiologists 2020  

  開催年月日：

  2020年10月

  　

  　

• カフェイン中毒の治療経過に際し薬物血中濃度の推移を検証し、胃内容物残存評価の有用性を再認識した１例

  佐藤 慧, 丹保, 亜希仁, 奥田, 勝博, 清水, 惠子, 南波, 仁, 一宮 尚裕, 山蔭 道明

  日本集中治療医学会第4回北海道支部学術集会  

  発表年月： 2020年09月

• 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)の症例

  佐藤 慧, 吉川 裕介, 山蔭 道明

  日本心臓血管麻酔学会第22回学術大会  

  発表年月： 2017年09月

• 危機的弛緩出血の一次的な止血にバソプレシン持続静注が奏功した一例

  佐藤 慧, 山﨑 治幸, 小林 佳郎

  第43回日本集中治療医学会学術集会  

  発表年月： 2016年02月

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