研究者詳細 - 宮脇　卓也

論文 - 宮脇　卓也

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障害者の生涯にわたる口腔のQOL向上を目的とした地域連携クリニカルパスの開発査読

江草正彦, 森貴幸, 大森潤, 村田尚道, 有岡享子, 北ふみ, 沼本庸子, 後藤拓朗, 神田ゆうこ, 小林幸生, 梶原京子, 石田瞭, 森田学, 宮脇卓也

岡山歯学会雑誌 31 ( 1 ) 1 - 13 2012年6月

担当区分：最終著者記述言語：日本語出版者・発行元：岡山歯学会

障害を有する歯科疾患患者が最少の負担で最適な歯科治療を受けられるよう支援することを目的として障害者歯科の地域連携クリニカルパス(以下パス)を開発し、A地区においてパイロット的に1年間運用した結果を報告した。また、パスの開発にあたり、地域の障害者における歯科の現状を把握し、パスの内容に反映させるために以下の調査を行ったので、併せて報告した。1)障害者における歯の保持状況と齲蝕の処置状況。2)障害者の歯科受診行動と歯科医療体制への希望。3)地域の一般歯科医師と障害者歯科との関わり。4)地域の歯科医療機関間における障害者の紹介状況。

岡山大学病院における地域ネットワークの構築食支援ネットワークを通じて査読

村田尚道, 有岡享子, 後藤拓朗, 石田瞭, 沼本庸子, 北ふみ, 森貴幸, 宮脇卓也, 江草正彦

日本歯科医療福祉学会雑誌 17 ( 1 ) 27 - 28 2012年6月

Effects of midazolam and phenobarbital on brain oxidative reactions induced by pentylenetetrazole in a convulsion model. 査読国際誌

Yukiko Arai, Shigeru Maeda, Hitoshi Higuchi, Yumiko Tomoyasu, Masahiko Shimada, Takuya Miyawaki

Immunopharmacology and immunotoxicology 34 ( 2 ) 216 - 21 2012年4月

担当区分：最終著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

CONTEXT: Brain oxidative reactions are involved in epilepsy as well as neurodegenerative diseases. In animal convulsion models, some anticonvulsants have been found to suppress oxidative reactions associated with convulsions. However, the effect of anticonvulsants on brain oxidative reactions has not fully been clarified. OBJECTIVE: Midazolam and phenobarbital are often used as an intravenous anesthetic, and are known to have anticonvulsive effect, but antioxidative effect of these drugs has rarely been studied. Thus, the purpose of this study was to evaluate the effects of these drugs on the degree of convulsions and brain oxidative reactions in an animal convulsion model. MATERIALS AND METHODS: In order to evaluate brain oxidative reactions, we measured malondialdehyde (MDA) level and heme oxygenase (HO)-1 mRNA expression level in the brain of mice in a convulsion model generated by a single injection of pentylenetetrazole (PTZ). We evaluated the effects of midazolam and phenobarbital on the degree of PTZ-induced convulsions and on the changes in brain MDA level and HO-1 mRNA expression level. RESULTS: After PTZ injection, severe convulsions were observed in all mice. MDA level was increased in the whole brain, while HO-1 mRNA expression level was increased only in the hippocampus. Both midazolam and phenobarbital prevented the convulsions and suppressed the increase in both MDA level and HO-1 mRNA expression level in the brain. CONCLUSION: In this study, both midazolam and phenobarbital suppressed PTZ-induced MDA and HO-1 reactions in the brain, suggesting that these drugs inhibit brain oxidative reactions in a convulsion model.

DOI： 10.3109/08923973.2011.595417

Combination of midazolam and a cyclooxygenase-2 inhibitor inhibits lipopolysaccharide-induced interleukin-6 production in human peripheral blood mononuclear cells. 査読国際誌

Takuya Miyawaki, Atsushi Kohjitani, Shigeru Maeda, Hitoshi Higuchi, Yukiko Arai, Yumiko Tomoyasu, Masahiko Shimada

Immunopharmacology and immunotoxicology 34 ( 1 ) 79 - 83 2012年2月

担当区分：最終著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

CONTEXT: Interleukin-6 (IL-6) plays an important role in immune and inflammatory responses. Midazolam has been reported to modulate IL-6 response. Cyclooxygenase (COX) inhibitors, which are used together with midazolam in some patients undergoing surgery, also modulate it. We hypothesized that their combination results in eliciting the synergistical effect on the IL-6 response. OBJECTIVE: The aim of the present study was to evaluate the effect of the combination of midazolam and a COX inhibitor on IL-6 production. MATERIALS AND METHODS: Peripheral blood mononuclear cells (PBMCs) were isolated from healthy volunteers and incubated with lipopolysaccharide (LPS), midazolam, and/or COX inhibitors, including indomethacin, SC-560, a COX-1 selective inhibitor, and NS-398, a COX-2 selective inhibitor. The supernatant concentrations of IL-6 and prostaglandins (PGs), including PGE2, PGF2α, PGD2, and 15-deoxy-Δ¹²,¹⁴-prostaglandin J2 (15dPGJ2) were measured. RESULTS: Midazolam had no effect on IL-6 production in the cells incubated for 12 h, and any COX inhibitors also had no effect. However, the combination of midazolam and NS-398 significantly inhibited it. Midazolam raised the concentration of 15dPGJ2 in the supernatant of the cells, but not the concentration of other PGs. DISSCUSSION AND CONCLUSION: The results in the present study demonstrated that the combination of midazolam and a COX-2 inhibitor inhibited LPS-induced IL-6 production in human PBMCs even if each drug separately did not have any effect on it. The finding suggests that their combination is effective against excessive IL-6 production such as severe inflammatory response and that the effect of midazolam on IL-6 production is possibly elicited via 15dPGJ2.

DOI： 10.3109/08923973.2011.577783

The influence of oral VPA on the required dose of propofol for sedation during dental treatment in patients with mental retardation: a prospective observer-blinded cohort study. 査読国際誌

Minako Ishii, Hitoshi Higuchi, Shigeru Maeda, Yumiko Tomoyasu, Masahiko Egusa, Takuya Miyawaki

Epilepsia 53 ( 1 ) e13-6 2012年1月

担当区分：最終著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

In sedation of dental patients with moderate or severe mental retardation, it is difficult to identify the optimum sedation level and to maintain it appropriately. Moreover, many patients have concomitant epilepsy and are medicated with oral antiepileptic drugs (AEDs), which influence the drug-metabolizing enzymes. In particular, valproate (VPA) has been demonstrated to inhibit propofol metabolism in vitro. Therefore, the objective of the present study was to investigate the clinical influence of oral VPA on the required dose of propofol for sedation, with use of a prospective cohort study design. We studied 45 patients with moderate or severe mental retardation who underwent dental treatment under sedation. Propofol was infused, and sedation was maintained at the same level in all patients using a bispectral index (BIS) monitor. After the completion of treatment for the scheduled patients, patients were divided into those with oral VPA treatment (VPA group: 20 patients) and without any oral antiepileptic treatment (control group: 25 patients). The propofol dose required for sedation and times to the recovery of the eyelash reflex and spontaneous eye opening were evaluated. The median required propofol doses in the VPA and control groups were 4.15 (range 1.97-5.88) and 5.67 (2.92-7.17) mg/kg/h, respectively. We observed a statistically significant difference between the two patient groups with respect to median VPA dose (p < 0.01). However, no statistically significant differences were noted in the time until eyelash reflex recovery or spontaneous eye opening between the two groups. The results suggest that oral VPA reduces the dose of propofol required for sedation during dental treatment in patients with moderate or severe mental retardation.

DOI： 10.1111/j.1528-1167.2011.03328.x

プロポフォールおよびレミフェンタニルを用いた鎮静法によって歯科治療時の異常絞扼反射が脱感作傾向を呈した症例査読

石井美菜子, 友安弓子, 新井由起子, 林知子, 山根彩加, 前田茂, 宮脇卓也

日本歯科麻酔学会雑誌 40 ( 1 ) 46 - 47 2012年1月

担当区分：最終著者記述言語：日本語出版者・発行元：(一社)日本歯科麻酔学会

51歳男。左上前歯部のブリッジ脱離による審美障害を主訴とした。重度の異常絞扼反射を有するため、静脈内鎮静法で処置することになり、初回はミダゾラムとプロポフォールを併用したが、絞扼反射を完全に抑制できなかった。そこで、プロポフォールとレミフェンタニルを用いた鎮静法に変更したところ、絞扼反射を良好に抑制し、合併症を認めることなく治療を行うことができた。また、約1年間に計10回、静脈内鎮静法を用いて処置を行ったが、10回目のプロポフォールの平均投与速度は初回の53.5%まで減少し、絞扼反射が脱感作傾向を呈した。重度の異常絞扼反射を有する患者の鎮静法では、処置中の異常絞扼反射の抑制だけでなく、反射の閾値を上昇させる点において、プロポフォールとレミフェンタニルを併用した鎮静法が有用と思われた。

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口腔外科手術時の止血のために用いたアドレナリン製剤(ボスミン注)によるアナフィラキシーが最も疑われた症例査読

矢吹明子, 齊田拓也, 友安弓子, 新井由起子, 前田茂, 宮脇卓也

日本歯科麻酔学会雑誌 40 ( 1 ) 48 - 49 2012年1月

担当区分：最終著者記述言語：日本語出版者・発行元：(一社)日本歯科麻酔学会

58歳男。右側下顎嚢胞摘出術と両側下顎智歯抜歯術が予定された。喘息やアレルギーの既往はなく、術前診査でも異常はなかったが、術中、右側下顎智歯抜歯後と左側下顎智歯抜歯中に換気障害が出現した。血圧低下などの循環器症状はなく、気管支狭窄音も聴取されなかったが、肺コンプライアンスの低下、呼気二酸化炭素濃度の上昇と、腹部筋硬直、軟口蓋の著明な浮腫、頸部及び顔面の紅潮を認め、気管支拡張薬の吸入とステロイド薬の投与を行ったところ、換気障害は改善した。症状発症時の血液検査で総IgEの著明な上昇を認めたことや経過を検証した結果から、アドレナリン製剤によるアナフィラキシーが疑われた。

Extreme tooth abnormalities and treatment under general anesthesia in a child with chronic GVHD surviving relapse of acute lymphoblastic leukemia. 査読国際誌

Shigeru Maeda, Michiyo Suda, Minako Ishii, Yumiko Tomoyasu, Hitoshi Higuchi, Yoshihide Okazaki, Masahiko Egusa, Takuya Miyawaki

The Journal of clinical pediatric dentistry 37 ( 2 ) 199 - 201 2012年

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

Treatment for acute lymphoblastic leukemia (ALL) mainly consists of chemotherapy, irradiation and bone marrow transplantation. In terms of long-term treatment effects, dental abnormalities and chronic graft-versus host disease (GVHD) are problems. We present a patient surviving relapse of ALL at one year of age. He had extreme dental abnormalities and multiple caries. Most of his permanent teeth were abnormal, and multiple caries were observed. Since he had a strong vomiting reaction to dental treatment, general anesthesia was given. During the general anesthesia, much sputum was aspirated because of chronic GVHD. His dental condition was worse than other cases reported previously. Since the survival rate has increased recently, the dental effects of ALL treatment have become significant. Especially, in patients undergoing total body irradiation at under 2 years of age, it is highly likely that dental problems will occur in the future.

Dental sedation for patients with intellectual disability: a prospective study of manual control versus Bispectral Index-guided target-controlled infusion of propofol. 査読国際誌

Mai Sakaguchi, Hitoshi Higuchi, Shigeru Maeda, Takuya Miyawaki

Journal of clinical anesthesia 23 ( 8 ) 636 - 42 2011年12月

担当区分：最終著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

STUDY OBJECTIVE: To investigate the use of propofol sedation using Bispectral Index (BIS)-guided target-controlled infusion (TCI) in dental patients with intellectual disability. DESIGN: Single-center, prospective, randomized clinical trial. SETTING: Academic outpatient clinic. SUBJECTS: 40 ASA physical status 1 and 2 patients with intellectual disability. INTERVENTIONS: Patients were randomized to two groups. The manual control (MC) group (n = 20) had sedation by manually controlled infusion of propofol without a BIS index monitor. The BIS-TCI group (n = 20) had sedation by BIS-guided TCI of propofol. MEASUREMENTS: The required dose of propofol, recovery time for the eyelash reflex, and spontaneous eye opening times were recorded. MAIN RESULTS: BIS-TCI significantly reduced the dose of propofol and shortened the recovery times for eyelash reflex and spontaneous eye opening. CONCLUSION: Propofol sedation using BIS-guided TCI is a useful and safe method in the management of patients with intellectual disability.

DOI： 10.1016/j.jclinane.2011.04.008

Propofol increases the rate of albumin-unbound free midazolam in serum albumin solution. 査読

Jun Ohmori, Shigeru Maeda, Hitoshi Higuchi, Minako Ishii, Yukiko Arai, Yumiko Tomoyasu, Atsushi Kohjitani, Masahiko Shimada, Takuya Miyawaki

Journal of anesthesia 25 ( 4 ) 618 - 20 2011年8月

担当区分：最終著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

Propofol and midazolam have a synergistic anesthetic action. One of the reasons for this is thought to be the inhibitory effect of propofol on midazolam metabolism. However, because both drugs bind strongly to serum protein, their interaction may not only involve the effects of propofol on midazolam metabolism, but may also involve propofol's effects on serum protein-binding. Against this background, we investigated the characteristics of midazolam binding to serum albumin, and evaluated the effects of both propofol and ketamine on this binding. Midazolam was added to a serum albumin solution with propofol or ketamine, and, after incubation for 1 h, albumin-free solution was separated from the sample and the midazolam concentration was measured using a high-performance liquid chromatography system. The albumin-unbound rate of midazolam was evaluated and compared with the rate in the control solution (only midazolam). Propofol significantly raised the rate of albumin-unbound free midazolam, while ketamine had no effect on the binding of midazolam to serum albumin. These findings suggest that the increase in albumin-unbound free midazolam brought about by propofol is involved in the synergistic effect of these two agents.

DOI： 10.1007/s00540-011-1176-6

Liposome-encapsulated midazolam for oral administration. 査読国際誌

Yumiko Tomoyasu, Tatsuji Yasuda, Shigeru Maeda, Hitoshi Higuchi, Takuya Miyawaki

Journal of liposome research 21 ( 2 ) 166 - 72 2011年6月

担当区分：最終著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

The oral administration of midazolam has often been used for sedation in pediatric patients. However, oral administration of an intravenous formulation of midazolam is difficult for younger pediatric patients because of its bitter taste. Liposomes have been developed as vesicles encapsulating various kinds of drugs to serve as a medical drug-delivery system. Thus, the aim of the present study was to produce pH-sensitive liposomes encapsulating midazolam and to evaluate its pharmacokinetics on rabbits. Liposome-encapsulated midazolam was produced from hydrogenated L-α-phosphatidylcholine, cholesterol, dipalmitoylphosphatidic acid, and midazolam. The capacity of liposomes to encapsulate midazolam (encapsulation efficiency), stability of encapsulation, and release efficiency were evaluated in vitro. Further, the produced liposome-encapsulated midazolam solution was orally administered to rabbits in vivo. As a result, midazolam was encapsulated by liposomes with a high encapsulation efficiency and was stably encapsulated in a physiological medium. Further, the produced liposomes rapidly and effectively released midazolam in an acidic medium in vitro. When the liposome-encapsulated midazolam solution was orally administered to rabbits, the time to achieve the maximum plasma concentration of midazolam after administration was slightly longer, but both the maximum plasma concentration and area under the concentration-time curve were higher than those receiving midazolam solution. In conclusion, we produced pH-sensitive liposome-encapsulated midazolam, which remained stable in a physiological medium and showed efficient release in an acidic environment. The results suggest that it is possible to clinically use liposome-encapsulated midazolam for oral administration as a useful drug-delivery vehicle.

DOI： 10.3109/08982104.2010.498002

Dandy-Walker症候群歯科患者の全身麻酔経験査読

須田通代, 吉田啓太, 山根彩加, 石井美菜子, 渡辺禎久, 前田茂, 宮脇卓也

日本歯科麻酔学会雑誌 39 ( 2 ) 230 - 231 2011年4月

担当区分：最終著者記述言語：日本語出版者・発行元：(一社)日本歯科麻酔学会

26歳男。小顎症を伴うDandy-Walker症候群患者であり、3ヵ月前に静脈内鎮静法で歯科治療を行った際、オトガイ挙上による気道確保が困難であったため、今回は全身麻酔法下での歯科治療が計画された。本症例は知的障害を有するため、正確な気道確保困難、挿管困難の術前評価が難しく、解剖学的な特徴から推測せざるをえなかったが、全身麻酔導入後の気管挿管を選択し、小顎症による気道確保困難に対して各種エアウェイ、ラリンジアルマスクを準備して管理に臨んだ。徒手にて気道確保を試みるも気道は閉塞気味であったため、ラリンジアルマスクによる気道確保後、気管挿管を施行し、円滑な全身麻酔を行うことができた。また、術中は特に異常なく、術後も気道管理上のトラブルはなかった。

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知覚痛覚定量分析装置(Pain Vision)を応用したオトガイ神経領域知覚異常の評価査読

新井由起子, 山根彩加, 矢吹明子, 迎和生, 須田通代, 友安弓子, 前田茂, 宮脇卓也

日本歯科麻酔学会雑誌 39 ( 2 ) 188 - 189 2011年4月

担当区分：最終著者記述言語：日本語出版者・発行元：(一社)日本歯科麻酔学会

オトガイ神経領域の知覚異常に対し、知覚痛覚定量分析装置(Pain Vision)を用いて最小感知電流値を測定し、知覚異常の定量的評価を行った。患側および健側の最小感知電流値、健側に対する患側の値の比(患側/健側)、患側と健側の値の差(患側-健側)、ならびに主観的評価としてvisual analogue scale(VAS)を比較した結果、健側の値には比較的大きな個体差が認められ、VASと患側/健側および患側-健側は同様の傾向がみられたが、VASと患側そのものの値との比較においては同様の傾向を示さなかった。Pain Visionは痛みを与えないこと、操作が容易であることなどの利点があり、痛みの評価だけでなく、知覚異常の定量的評価に有用である可能性が示唆された。

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Induction of apoptotic change in the rat hippocampus caused by ferric nitrilotriacetate. 査読国際誌

Shigeru Maeda, Yukiko Arai, Hitoshi Higuchi, Yumiko Tomoyasu, Ryuichiro Mizuno, Toru Takahashi, Takuya Miyawaki

Redox report : communications in free radical research 16 ( 3 ) 114 - 20 2011年

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

Iron, a source of oxidative stress, plays a major role in the pathology of neurodegenerative disease. In Alzheimer's disease, the hippocampus is vulnerable to oxidative stress, leading to impairment in memory formation. In our previous study, a brain oxidative reaction was induced after intraperitoneal injection of ferric nitrilotriacetate (Fe-NTA). However, since only a small amount of iron reached the brain in the previous study, Fe-NTA was administered into the hippocampus using an osmotic pump in this study. After continuous injection of Fe-NTA for 2 weeks, a high level of apoptotic change was induced in the hippocampus, in accordance with the iron localization. After injection for 4 weeks, the hippocampus was totally destroyed. A small amount of iron infiltrated into the cerebral cortex and the striatum, and deposition was observed at the choroid plexus and ependymal cells. However, no apoptotic reaction or clear tissue injury was observed in these areas. In addition, muscarinic acetylcholine receptors (M1, M2, and M4) were decreased in both the cortex and hippocampus while it increased in the striatum. Thus, the hippocampus is likely vulnerable to oxidative stress from Fe-NTA, and the oxidative stress is considered to bring the disturbance in the muscarinic acetylcholine receptors.

DOI： 10.1179/174329211X13049558293597

Allergic reactions to local anesthetics in dental patients: analysis of intracutaneous and challenge tests. 査読国際誌

Yumiko Tomoyasu, Kazuo Mukae, Michiyo Suda, Tomoko Hayashi, Minako Ishii, Mai Sakaguchi, Yoshihisa Watanabe, Ayako Jinzenji, Yukiko Arai, Hitoshi Higuchi, Shigeru Maeda, Takuya Miyawaki

The open dentistry journal 5 146 - 9 2011年

担当区分：最終著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

Some dental patients have histories of adverse reactions to local anesthesia. The aim of the present study was to investigate the frequency of allergy to local anesthetics of dental patients who had histories of adverse reactions to local anesthesia based on the results of allergy tests in our institute over a period of 5 years. We investigated the past medical records of dental patients retrospectively, and twenty patients were studied. Three of the 20 showed a positive or false-positive reaction in the intracutaneous test, and one patient showed a false-positive reaction in the challenge test. Our results suggest that the frequency of allergy to local anesthetics is low even if patients have histories of adverse reactions to local anesthesia. However, allergy tests of local anesthetics should be performed in patients in whom it is uncertain whether they are allergic.

DOI： 10.2174/1874210601105010146

Brugada型心電図を呈する口腔外科患者2症例の全身麻酔経験査読

秦泉寺紋子, 矢吹明子, 新井由起子, 前田茂, 宮脇卓也

岡山歯学会雑誌 29 ( 2 ) 113 - 118 2010年12月

担当区分：最終著者記述言語：日本語出版者・発行元：岡山歯学会

Brugada型心電図を呈する口腔外科患者の全身麻酔2例を経験した。症例1は53歳男で、口蓋部良性腫瘍で腫瘍摘出術を予定した。術前検査で、Brugada型心電図と診断した。麻酔導入はプロポフォール、セボフルラン、レミフェンタニルで開始し、血圧低下、徐脈を認め、麻酔薬の投与量の減量と、アトロピン硫酸塩、エフェドリン塩酸塩で回復した。維持はセボフルラン、レミフェンタニルで行った。術中および術後に心電図上ST変化は認められず、不整脈の出現もなかった。症例2は35歳男で、下顎骨骨折で観血的整復固定術を予定した。術前検査で、Brugada型心電図と診断した。麻酔導入はプロポフォール、セボフルラン、レミフェンタニルで開始した。維持はセボフルラン、レミフェンタニルで行った。術中は心拍数の低下を認め、アトロピン硫酸塩で回復した。術中・術後ともに心電図上ST変化はなく、不整脈等の出現はなかった。

Partial laryngospasms during general anesthesia with a laryngeal mask airway for dental treatment: a report of 5 cases. 査読国際誌

Ayako Jinzenji, Shigeru Maeda, Hitoshi Higuchi, Keita Yoshida, Takayuki Mori, Masahiko Egusa, Takuya Miyawaki

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 68 ( 10 ) 2554 - 7 2010年10月

口腔外科手術患者の術後鎮静における塩酸デクスメデトミジンをベースとしたプロポフォールによるPatient-Controlled Sedationの有効性の検討査読

石井美菜子, 樋口仁, 秦泉寺紋子, 林知子, 坂口舞, 新井由起子, 渡辺禎久, 友安弓子, 吉田啓太, 前田茂, 宮脇卓也

日本歯科麻酔学会雑誌 38 ( 3 ) 279 - 283 2010年7月

担当区分：最終著者記述言語：日本語出版者・発行元：(一社)日本歯科麻酔学会

口腔外科手術後の気管チューブ留置中の鎮静において、塩酸デクスメデトミジン(以下DEX)をベースとしたプロポフォールによるPatient-Controlled Sedation(以下PCS)の有効性を検討した。顎骨骨切り術を施行した患者を対象とし、DEXのみで鎮静を行った群(DEX群)、DEXをベースとしたプロポフォールによるPCSを用いて鎮静を行った群(DEX+PCS群)の2群に分け、年齢、性別、体重、手術術式、平均薬剤投与速度、鎮静中の苦痛の有無、鎮静中の健忘の有無および鎮静中の合併症をレトロスペクティブに比較した。両群間において患者背景に有意差は認められなかった。DEX群はDEX+PCS群と比較し、有意にDEXの平均投与速度が多かった。苦痛緩和はDEX群と比較してDEX+PCS群において有意に認められたが、健忘効果は両群間において有意差は認められなかった。以上のことより、口腔外科手術後の気管チューブ留置中の鎮静において、DEXをベースとしたプロポフォールによるPCSは患者の苦痛を軽減するのに有効な方法であることが示唆された。(著者抄録)

卒前歯学臨床教育における学外インターンシップ実習の構築と今後の展望査読

前川賢治, 窪木拓男, 伊澤俊次, 皆木省吾, 高柴正悟, 宮脇卓也, 江草正彦, 木村年秀, 山本敏男, 森田学, 佐々木朗, 松尾龍二

岡山歯学会雑誌 29 ( 1 ) 35 - 40 2010年6月

肥大型心筋症、非持続性心室頻拍既往患者の口腔外科手術における全身管理経験査読

吉田啓太, 林知子, 迎和生, 須田通代, 石井美菜子, 坂口舞, 友安弓子, 渡辺禎久, 秦泉寺紋子, 前田茂, 宮脇卓也

岡山歯学会雑誌 29 ( 1 ) 51 - 53 2010年6月

担当区分：最終著者記述言語：日本語出版者・発行元：岡山歯学会

患者は66歳男で、左下顎歯根嚢胞に対して嚢胞摘出術+左下顎6抜歯術を予定されたが、肥大型心筋症、非持続性心室頻拍、甲状腺機能低下症など多くの疾患を伴っており、周術期合併症が危惧された。そこで、静脈内鎮静法下に全身管理を行い、良好な経過が得られた。

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