2025/04/09 更新

写真a

タカホコ　ケンイチ
鷹架　健一
TAKAHOKO Ken-ichi
所属
病院 診療科 麻酔科蘇生科
外部リンク

学位

  • 博士（医学） （ 2022年3月   旭川医科大学 ）

学歴

  • 旭川医科大学   大学院医学系研究科

    2015年9月 - 2022年3月

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    国名： 日本国

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経歴

  • 旭川医科大学   助教

    2015年4月 - 現在

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所属学協会

  • 日本区域麻酔学会

    2022年12月 - 現在

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論文

  • Comparison of supramaximal currents obtained by acceleromyography and electromyography for monitoring the adductor pollicis muscle in pediatric patients. 査読 国際誌

    Hajime Iwasaki, Kenichi Takahoko, Chihiro Yamagata, Yudai Nambu, Ayaka Suzuki, Yui Takada, Sarah Kyuragi Luthe, Hiroshi Makino

    Journal of clinical monitoring and computing   2025年3月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER HEIDELBERG  

    The aim of this study was to compare the supramaximal currents obtained simultaneously by acceleromyography (AMG) TOF-Watch® SX and electromyography (EMG) AF-201P in pediatric patients. Patients aged 2-11 years who underwent elective surgery under general anesthesia were enrolled. AMG and EMG monitors were placed on opposite arms of the patient to stimulate the ulnar nerve and monitor the adductor pollicis muscles following the induction of general anesthesia. After the monitors were calibrated, rocuronium 0.6 mg/kg was administered. Endotracheal intubation was performed when the EMG showed a train-of-four (TOF) count of 0. The primary outcome was the supramaximal current set by each device's calibration. The secondary outcomes were the time from the administration of rocuronium to a TOF count of 0, the baseline and final TOF ratios, and the conditions surrounding intubation. The paired t test and the Wilcoxon signed-rank test were used to analyze parametric and nonparametric data. A P value < 0.05 indicated statistical significance. Clinical data from 25 pediatric patients were analyzed. The supramaximal current was significantly lower with EMG than with AMG (27.4 ± 6.1 vs. 54.2 ± 8.4 mA, p <.001). The time to a TOF count of 0 was significantly shorter with EMG than with AMG (58 [24-170] vs. 75 [26-236] seconds, p <.001). Both the baseline and final TOF ratios were significantly lower with EMG than with AMG. The ease of laryngoscopy was rated as excellent for all patients. The vocal cords were abducted in 76% of patients, and no movement to insertion of the endotracheal tube was confirmed in 96% of patients. We found that the supramaximal current was significantly lower with EMG than with AMG.

    DOI： 10.1007/s10877-025-01286-y

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  • Laryngospasm Treated With Intramuscular Rocuronium in a Pediatric Patient Without Intravenous Access: A Case Report. 査読 国際誌

    Hiroki Tabata, Kenichi Takahoko, Sarah K Luthe, Hiroshi Makino, Hajime Iwasaki

    Cureus   16 ( 3 )   e56620   2024年3月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGERNATURE  

    We present a case in which intramuscular rocuronium was used successfully to treat laryngospasm in a pediatric patient. An 11-month-old infant weighing 9.7 kg was scheduled for an elective laparoscopic inguinal hernia repair surgery. Anesthesia was induced with oxygen, nitrous oxide, and sevoflurane. After loss of consciousness, mask ventilation became impossible, and laryngospasm was suspected. Intravenous access was attempted without success; as there was no immediate access to succinylcholine, rocuronium 10 mg (1.0 mg/kg) was injected intramuscularly into the vastus lateralis muscle. We were able to mask-ventilate the patient within one minute of intramuscular rocuronium, followed by successful endotracheal intubation with a video laryngoscope. The duration of hypoxia (saturation of peripheral oxygen (SpO2) < 90%) was approximately two minutes, and the patient's lowest oxygen saturation during induction was 76%. At the end of the surgery, the patient was uneventfully extubated. We conclude that intramuscular rocuronium may provide an alternative treatment for laryngospasm in pediatric patients with no intravenous access and no availability of succinylcholine.

    DOI： 10.7759/cureus.56620

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  • MitraClip術中に心腔内に空気が混入した1症例 査読

    高橋 裕香子, 鷹架 健一

    臨床麻酔   47 ( 9 )   1076 - 1077   2023年10月

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    担当区分：最終著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(株)シービーアール  

    63歳男。MitraClip術中に経食道心エコーで心腔内に多量の空気が描出されたため、pigtail catheterで空気を吸引し、重篤な空気塞栓症を回避することができた。Clip delivery systemのフラッシュポートが破損していたことが術後に判明し、心腔内に空気が混入した原因と考えられた。

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  • Impact of intraoperative fluid restriction on renal outcomes in patients undergoing robotic-assisted laparoscopic prostatectomy. 査読 国際誌

    Chie Mori, Hajime Iwasaki, Izumi Sato, Kenichi Takahoko, Yosuke Inaba, Yohei Kawasaki, Gaku Tamaki, Hidehiro Kakizaki

    Journal of robotic surgery   17 ( 5 )   1989 - 1993   2023年10月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGERNATURE  

    Robotic-assisted laparoscopic prostatectomy (RALP) requires intraoperative fluid restriction to maintain the optimal view of the operative field during vesicourethral anastomosis and to prevent upper airway edema that may occur due to the steep Trendelenburg position. The aim of this study was to demonstrate that our fluid restriction regimen would not increase postoperative serum creatinine (sCr) levels in patients undergoing RALP. The fluid regimen involved maintaining a crystalloid infusion at 1 ml/kg/h until completion of vesicourethral anastomosis, then rapid infusion of 15 ml/kg within 30 min, followed by maintenance at 1.5 ml/kg/h until post-operative day (POD) 1. The primary outcome of this study was the change in the sCr level from baseline to POD7. Secondary outcomes were the sCr levels on PODs 1 and 2, the surgical view during vesicourethral anastomosis, and the incidences of re-intubation and acute kidney injury (AKI). Sixty-six patients were eligible for the analysis. The paired t test for non-inferiority showed no significant difference in sCr levels between baseline and POD7 (mean ± standard deviation, 0.79 ± 0.14 vs. 0.80 ± 0.18 mg/dl, p < 0.001). Seven patients developed AKI on POD1, but all but one recovered on POD2. Ninety-seven percent of operations were rated as having a good view of the operative field. There were no cases of re-intubation. This study demonstrated that the fluid restriction regimen of 1 ml/kg/h until completion of vesicourethral anastomosis created a good view of the operative field during vesicourethral anastomosis without increasing postoperative sCr levels in patients undergoing RALP. Trial registration: This trial was registered in the University Hospital Medical Information Network under registration number UMIN000018088 (registration date; July 1, 2015).

    DOI： 10.1007/s11701-023-01610-1

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  • The impact of electrosurgical devices on electromyography-based neuromuscular monitoring during abdominal laparotomy: a case series. 査読 国際誌

    Hajime Iwasaki, Kenichi Takahoko, Takuro Matsui, Yui Takada, Yukako Takahashi, Ami Sugawara, Atsushi Kurosawa

    Journal of clinical monitoring and computing   37 ( 4 )   1111 - 1114   2023年8月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER HEIDELBERG  

    The present study aimed to evaluate the effect of electrosurgical devices on neuromuscular monitoring using an electromyography (EMG)-based neuromuscular monitor during abdominal laparotomy. Seventeen women (aged 32-64 years) undergoing gynecological laparotomy under total intravenous general anesthesia were enrolled in the study. A TetraGraph™ was placed to stimulate the ulnar nerve and to monitor the abductor digiti minimi muscle. After device calibration, train-of-four (TOF) measurements were repeated at intervals of 20 s. Rocuronium 0.6 to 0.9 mg/kg was administered for induction, and additional doses of 0.1 to 0.2 mg/kg were administered to maintain TOF counts ≤ 2 during the surgery. The primary outcome of the study was the ratio of measurement failure. The secondary outcomes of the study were the total number of measurements, the number of measurement failures, and the most extended consecutive number of measurement failures. The data are expressed as median (range). Of the 3091 (1480-8134) measurements, the number of measurement failures was 94 (60-200), resulting in a failure ratio of 3.5% (1.4-6.5%). The most extended consecutive number of measurement failures was 8 (4-13). All attending anesthesiologists were able to maintain and reverse neuromuscular blocks under EMG guidance. This prospective observational study demonstrated that the use of EMG-based neuromuscular monitoring does not seem to be heavily affected by electrical interference during lower abdominal laparotomic surgery. Trial registration This trial was registered in the University Hospital Medical Information Network under registration number UMIN000048138 (registration date; June 23, 2022).

    DOI： 10.1007/s10877-023-01039-9

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  • Comparing Conscious Sedation With Regional Anesthesia Versus General Anesthesia in Minimally Invasive Mitral Valve Surgery With Right-Sided Minithoracotomy: A Retrospective Study 査読 国際誌

    Hirotsugu Kanda, Yukako Takahashi, Ami Sugawara, Kenichi Takahoko, Tomonori Shirasaka, Yasuaki Saijo, Hiroyuki Kamiya

    J Cardiothorac Vasc Anesth .   36 ( 2 )   452 - 460   2022年2月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    DOI： 10.1053/j.jvca.2021.07.005

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  • The Association Between Intraoperative Objective Neuromuscular Monitoring and Rocuronium Consumption During Laparoscopic Abdominal Surgery: A Single-Center Retrospective Analysis 査読 国際誌

    Kenichi Takahoko, Hajime Iwasaki, Yosuke Inaba, Takashi Matsuno, Risako Matsuno, Sarah K Luthe, Hirotsugu Kanda, Yohei Kawasaki

    Cureus   13 ( 11 )   e19245   2021年11月

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    担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

    DOI： 10.7759/cureus.19245

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  • SmartPilot ViewにOrchestraを接続して覚醒下脳腫瘍摘出術の麻酔管理を行った一症例 査読

    高橋 裕香子, 鷹架 健一, 菅原 亜美

    麻酔・集中治療とテクノロジー   2020   24 - 26   2021年3月

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    記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本麻酔・集中治療テクノロジー学会  

    症例は20代男性で、左前頭葉腫瘍に対して覚醒下脳腫瘍摘出術が予定された。麻酔導入はプロポフォールの効果部位-TCIを初期標的濃度4μg/mLで行った。意識消失時のSmartPilot View(SPV)に表示されたプロポフォール効果部位濃度は5.07μg/mLであった。意識消失確認後、レミフェンタニルの効果部位-TCIを初期標的濃度4μg/mLで開始し、フェンタニル1μg/kgを単回投与した。術中はBIS値とSPVを参考にし、覚醒試験に合わせてプロポフォールとレミフェンタニルの効果部位濃度を適宜調節した。腫瘍切除後、プロポフォールの目標効果部位濃度を1.7μg/mLで再開し、SPVを参考にフェンタニルの単回投与と持続投与を行い、自発呼吸下で管理した。術中に呼吸抑制は認めなかった。覚醒下手術の麻酔管理において、覚醒試験に応じた覚醒度の把握や覚醒時間の予測が重要であるため、SPVと効果部位-TCIを併用することで薬物の投与量の調節が容易であった。

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  • ハプトグロビン投与と人工心肺後急性腎障害の関連についての検討 傾向スコアマッチング解析 招待 査読

    鷹架 健一, 朝井 裕一, 呉 健太, 神田 浩嗣, 国沢 卓之

    Cardiovascular Anesthesia   24 ( 1 )   35 - 40   2020年8月

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    担当区分：筆頭著者,　責任著者   記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本心臓血管麻酔学会  

    【目的】人工心肺下開心術中のハプトグロビン(Haptoglobin:Hp)投与と術後急性腎障害(acute kidney injury:AKI)発症率の関連について後ろ向きに検討した。【方法】人工心肺下開心術を受けた成人患者142名の術後AKI発症率を,溶血尿出現時Hpを投与されたHp群と溶血尿出現せずHpを投与されなかった対照群とで傾向スコアマッチング法を用いて比較した。【結果】全体のAKI発症率は37%,Hp投与率は29%であった。全患者でのHp群におけるAKI発症率は53.7%であり,対照群の29.7%と比較して有意に高かった(P=0.013)。傾向スコアでマッチングした両群27名の解析では両群に有意差はなかった(48.1% vs 40.7%,P=0.78)。【結論】溶血尿出現時のHp投与は術後AKI発症率と関連しないことが示唆された。(著者抄録)

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    その他リンク： https://search.jamas.or.jp/default/link?pub_year=2020&ichushi_jid=J05198&link_issn=&doc_id=20200911160005&doc_link_id=%2Fca4crbam%2F2020%2F002401%2F005%2F0035-0040%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fca4crbam%2F2020%2F002401%2F005%2F0035-0040%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 当院におけるマニュアルTCIの試み 査読

    島田 舞衣, 鷹架 健一, 菅原 亜美, 国沢 卓之

    麻酔・集中治療とテクノロジー   2019   89 - 91   2020年3月

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    記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本麻酔・集中治療テクノロジー学会  

    症例は60歳男性で、急性大動脈解離術後の左反回神経麻痺に対して甲状軟骨形成術が予定された。術野での局所麻酔に加えて、術中鎮静はフェンタニルとデクスメデトミジンを使用した。投与開始時の単回投与量と持続投与量は事前にTivatrainerを利用して検討し、投与開始後は麻酔情報システム(ORSYS)に表示される予測血中濃度の未来予測と、シミュレーターを利用したマニュアルTarget-controlled infusionを行った。薬剤に応じて使用可能なシリンジポンプが規定されており、本症例ではプレセデックスとフェンタニルを使用するため、それぞれTE-371、TE-351を使用した。ORSYSと接続して認識された際、薬剤名の欄で「ポンプ取り込み(静注)」の段が表示されるようになり、TE-371の場合、送液中は緑回転点滅表示であるが、データ通信中は緑全点滅も追加表示される。シリンジポンプから該当薬剤投与後1分程度でORSYSヘデータが取り込まれ数値が表示される。また、シリンジポンプから自動取得した投与情報の予測血中濃度を表示させることが可能である。

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  • Awake double valve surgery without general anesthesia. 査読 国際誌

    Hirotsugu Kanda, Hiroyuki Kamiya, Kenichi Takahoko, Syuichi Yamaya, Eri Kudo, Takayuki Kunisawa

    Journal of clinical anesthesia   56   117 - 118   2019年9月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

    DOI： 10.1016/j.jclinane.2019.01.025

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  • Duration of the action of rocuronium in patients with BMI of less than 25: An observational study. 査読 国際誌

    Osamu Takahata, Ken-Ichi Takahoko, Tomoki Sasakawa, Yasuyoshi Inagaki, Hiroyuki Takahoko, Takayuki Kunisawa

    European journal of anaesthesiology   35 ( 11 )   863 - 866   2018年11月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）  

    BACKGROUND: The duration of rocuronium in patients with BMI more than 30 kg m is prolonged. Whether the reverse is true when BMI is less than 18.5 kg m is unclear. OBJECTIVE: The objective of this study was to investigate whether a BMI less than 25 kg m affects the duration of rocuronium in doses adjusted for actual body weight. DESIGN: A prospective, observational, single-centre study. SETTING: The operating room of a teaching hospital from 1 June 2008 to 30 June 2015. PATIENTS: Thirty patients with American Society of Anesthesiologists physical status I or II who were scheduled to undergo elective surgery (BMI < 25 kg m, aged 23 to 74 years) maintained by 0.7 minimum alveolar concentration sevoflurane and remifentanil. MAIN OUTCOME MEASURES: Repetitive train-of-four stimulation was applied and contractions of the adductor pollicis muscle were recorded. Duration of the initial dose of rocuronium (D1) was defined as the time from injection of rocuronium 0.6 mg kg to return of first twitch height to 25% of the control. Duration of additional doses (D2) was the time from a supplement of 0.15 mg kg rocuronium to return of first twitch height to 25% of the control. The relationship between D1 or D2 and BMI was examined using linear regression analysis. RESULTS: Linear regression analysis revealed a significant correlation between duration of initial dose and BMI (R = 0.246; P = 0.00531). A significant correlation between the duration of the additional dose and BMI was also found (R = 0.316; P = 0.00122). CONCLUSION: The lower the BMI, the shorter the duration of rocuronium at initial and additional doses determined by the actual body weight in adult patients with a BMI less than 25 kg m. TRIAL REGISTRATION: www.umin.ac.jp/ctr/index/htm with registry number UMIN 00009337 and UMIN 000015407.

    DOI： 10.1097/EJA.0000000000000823

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  • A case series of re-establishment of neuromuscular block with rocuronium after sugammadex reversal. 査読

    Hajime Iwasaki, Tomoki Sasakawa, Kenichi Takahoko, Shunichi Takagi, Hideki Nakatsuka, Takahiro Suzuki, Hiroshi Iwasaki

    Journal of anesthesia   30 ( 3 )   534 - 7   2016年6月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

    We report the use of rocuronium to re-establish neuromuscular block after reversal with sugammadex. The aim of this study was to investigate the relationship between the dose of rocuronium needed to re-establish neuromuscular block and the time interval between sugammadex administration and re-administration of rocuronium. Patients who required re-establishment of neuromuscular block within 12 h after the reversal of rocuronium-induced neuromuscular block with sugammadex were included. After inducing general anesthesia and placing the neuromuscular monitor, the protocol to re-establish neuromuscular block was as follows. An initial rocuronium dose of 0.6 mg/kg was followed by additional 0.3 mg/kg doses every 2 min until train-of-four responses were abolished. A total of 11 patients were enrolled in this study. Intervals between sugammadex and second rocuronium were 12-465 min. Total dose of rocuronium needed to re-establish neuromuscular block was 0.6-1.2 mg/kg. 0.6 mg/kg rocuronium re-established neuromuscular block in all patients who received initial sugammadex more than 3 h previously. However, when the interval between sugammadex and second rocuronium was less than 2 h, more than 0.6 mg/kg rocuronium was necessary to re-establish neuromuscular block.

    DOI： 10.1007/s00540-016-2159-4

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  • A temporary decrease in twitch response following reversal of rocuronium-induced neuromuscular block with a small dose of sugammadex in a pediatric patient. 査読

    Hajime Iwasaki, Kenichi Takahoko, Shigeaki Otomo, Tomoki Sasakawa, Takayuki Kunisawa, Hiroshi Iwasaki

    Journal of anesthesia   28 ( 2 )   288 - 90   2014年4月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

    We report a temporary decrease in twitch response following reversal of rocuronium-induced neuromuscular block with a small dose of sugammadex in our dose-finding study in pediatric patients. A 19-month-old female infant (9.6 kg, 80 cm) was scheduled for elective cheiloplasty surgery. Anesthesia was induced with nitrous oxide 50% and sevoflurane 5% and maintained with air, oxygen, sevoflurane 3%, and fentanyl (total, 3 μg/kg). Neuromuscular monitoring was performed at the adductor pollicis muscle after induction of anesthesia but before the administration of rocuronium. Total dose of rocuronium during the surgery was 0.9 mg/kg. Neuromuscular block was reversed with 0.5 mg/kg sugammadex when one response was observed with post-tetanic count stimulation. Twitch responses after sugammadex administration showed a temporary decrease after its initial recovery. Maximum decreases in twitch responses were observed 17 min after initial dose of sugammadex. Twitch responses recovered to their control values after additional doses of 3.5 mg/kg sugammadex (4 mg/kg in total). Time from sugammadex administration to maximum decreases in twitch responses is earlier than has been reported in adults (20-70 min). It is demonstrated that following neuromuscular block reversal with insufficient dose of sugammadex, there is a possibility of the recurrence of residual paralysis within less than 20 min in pediatric patients.

    DOI： 10.1007/s00540-013-1688-3

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  • Prediction of optimal reversal dose of sugammadex after rocuronium administration in adult surgical patients. 査読 国際誌

    Shigeaki Otomo, Hajime Iwasaki, Kenichi Takahoko, Yoshiko Onodera, Tomoki Sasakawa, Takayuki Kunisawa, Hiroshi Iwasaki

    Anesthesiology research and practice   2014   848051 - 848051   2014年

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：HINDAWI LTD  

    The objective of this study was to determine the point after sugammadex administration at which sufficient or insufficient dose could be determined, using first twitch height of train-of-four (T1 height) or train-of-four ratio (TOFR) as indicators. Groups A and B received 1 mg/kg and 0.5 mg/kg of sugammadex, respectively, as a first dose when the second twitch reappeared in train-of-four stimulation, and Groups C and D received 1 mg/kg and 0.5 mg/kg of sugammadex, respectively, as the first dose at posttetanic counts 1-3. Five minutes after the first dose, an additional 1 mg/kg of sugammadex was administered and changes in T1 height and TOFR were observed. Patients were divided into a recovered group and a partly recovered group, based on percentage changes in T1 height after additional dosing. T1 height and TOFR during the 5 min after first dose were then compared. In the recovered group, TOFR exceeded 90% in all patients at 3 min after sugammadex administration. In the partly recovered group, none of the patients had a TOFR above 90% at 3 min after sugammadex administration. An additional dose of sugammadex can be considered unnecessary if the train-of-four ratio is ≥90% at 3 min after sugammadex administration. This trial is registered with UMIN000007245.

    DOI： 10.1155/2014/848051

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  • Unilateral hypoglossal nerve palsy after use of the laryngeal mask airway supreme. 査読 国際誌

    Kenichi Takahoko, Hajime Iwasaki, Tomoki Sasakawa, Akihiro Suzuki, Hideki Matsumoto, Hiroshi Iwasaki

    Case reports in anesthesiology   2014   369563 - 369563   2014年

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    担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

    Purpose. Hypoglossal nerve palsy after use of the laryngeal mask airway (LMA) is an exceptionally rare complication. We present the first case of unilateral hypoglossal nerve palsy after use of the LMA Supreme. Clinical Features. A healthy 67-year-old female was scheduled for a hallux valgus correction under general anesthesia combined with femoral and sciatic nerve blocks. A size 4 LMA Supreme was inserted successfully at the first attempt and the cuff was inflated with air at an intracuff pressure of 60 cmH2O using cuff pressure gauge. Anesthesia was maintained with oxygen, nitrous oxide (67%), and sevoflurane under spontaneous breathing. The surgery was uneventful and the duration of anesthesia was two hours. The LMA was removed as the patient woke and there were no immediate postoperative complications. The next morning, the patient complained of dysarthria and dysphasia. These symptoms were considered to be caused by the LMA compressing the nerve against the hyoid bone. Conservative treatment was chosen and the paralysis recovered completely after 5 months. Conclusion. Hypoglossal nerve injury may occur despite correct positioning of the LMA under the appropriate intracuff pressure. A follow-up period of at least 6 months should be taken into account for the recovery.

    DOI： 10.1155/2014/369563

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  • Monitoring of neuromuscular blockade in one muscle group alone may not reflect recovery of total muscle function in patients with ocular myasthenia gravis. 査読 国際誌

    Hajime Iwasaki, Kenichi Takahoko, Shigeaki Otomo, Tomoki Sasakawa, Takayuki Kunisawa, Hiroshi Iwasaki

    Canadian journal of anaesthesia = Journal canadien d'anesthesie   60 ( 12 )   1222 - 7   2013年12月

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    記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

    PURPOSE: We report on two patients with ocular myasthenia gravis who received rocuronium, followed later by sugammadex to reverse neuromuscular blockade. Recovery was monitored simultaneously at the adductor pollicis muscle (APM) and the corrugator supercilii muscle (CSM). CLINICAL FEATURES: Two patients with ocular myasthenia gravis (case 1: 74 yr-old female, 54 kg; case 2: 71 yr-old male, 72 kg) were scheduled for surgery under general anesthesia. Neuromuscular blockade was induced with rocuronium 0.3 mg·kg(-1) after placing two separate monitors at the APM and the CSM, respectively. Additional doses of rocuronium 0.1-0.2 mg·kg(-1) were given to maintain neuromuscular blockade at fewer than two twitches at the APM during surgery. Train-of-four response at the CSM did not show recovery of the twitch after its initial disappearance. At the end of surgery, sugammadex was administered. Twitch height at the APM recovered to the control value in 12 min (case 1) and 13 min (case 2) after sugammadex administration; however, twitch height at the CSM took 26 min (case 1) and 14 min (case 2) to recover to the control value. CONCLUSION: After rocuronium-induced paralysis in both patients with ocular myasthenia, spontaneous recovery and sugammadex-assisted recovery were slower at the CSM than at the APM. In patients without the disorder, CSM recovery is faster than APM recovery. Thus, in ocular myasthenia gravis, neuromuscular recovery at the APM may not reflect recovery of all muscles.

    DOI： 10.1007/s12630-013-0042-4

    Web of Science

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  • 2型糖尿病患者におけるTOFウォッチSXを用いた筋弛緩モニタリングの留意点 査読

    岩崎 肇, 鷹架 健一, 大友 重明, 笹川 智貴, 国沢 卓之, 岩崎 寛

    麻酔   62 ( 8 )   929 - 34   2013年8月

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    記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：克誠堂出版(株)  

    気管挿管下に全身麻酔を行い、TOFウォッチSXを用いて母指内転筋運動の筋弛緩モニタリングを行った20-69歳の2型糖尿病患者(DM群)13症例、非糖尿病患者(non DM群)21症例を対象とし、CAL2後の最大上刺激電流(STIM)、加速度計の感度(SENS)、ロクロニウム0.6mg・kg-1投与後のTOF刺激反応消失までの時間(onset)、onsetからT1出現までの時間(T1 appearance)、T1出現からT2出現までの時間(T1-T2 time)について後ろ向きに検討した。DM群ではnon DM群と比較し、有意にSENSが高かった。また、デスフルランで麻酔を行ったDM群7名、non DM群7名においては、前者のT1 appearance、T1-T2 timeが有意に長く、それぞれにSENSとの相関関係を認めた。TOFウォッチSXを用いて2型糖尿病患者の筋弛緩モニタリングをする場合、非糖尿病患者に比べ加速度計の感度が有意に高く設定されるため、筋弛緩程度を過小評価する可能性があることが示唆された。(著者抄録)

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    その他リンク： https://search.jamas.or.jp/default/link?pub_year=2013&ichushi_jid=J01397&link_issn=&doc_id=20130806040004&doc_link_id=1520572359223700480&url=https%3A%2F%2Fcir.nii.ac.jp%2Fcrid%2F1520572359223700480&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

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  • Hypotension Prediction Index (HPI) を活かした術中低血圧予防と行動変容の促進 招待

    鷹架 健一

    日本麻酔科学会 北海道・東北支部 第14回学術集会  2024年9月 

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    開催年月日： 2024年9月

    記述言語：日本語   会議種別：公開講演，セミナー，チュートリアル，講習，講義等  

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  • Hypotension Prediction Index を活かした低血圧予防と行動変容の促進 招待

    鷹架 健一

    日本区域麻酔学会 第11回学術集会  2024年4月 

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    開催年月日： 2024年4月

    記述言語：日本語   会議種別：公開講演，セミナー，チュートリアル，講習，講義等  

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