Faculty Profiles - HIGUCHI Hitoshi

Papers - HIGUCHI Hitoshi

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Genetic basis of agedependent synaptic abnormalities in the retina Reviewed

Hitoshi Higuchi , Erica L. Macke, Wei-Hua Lee, Sam A. Miller, James C. Xu, Sakae Ikeda, Akihiro Ikeda

Mammalian Genome 26 ( 1 ) 21 - 32 2015.2

骨形成不全症患児の全身麻酔下歯科治療の周術期にデクスメデトミジン塩酸塩を用いた１例 Reviewed

谷村博史, 樋口仁, 高谷久美子, 平野彩加, 前田茂, 友安弓子, 宮脇卓也

日本歯科麻酔学会雑誌 43 ( 1 ) 51 - 53 2015.1

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本歯科麻酔学会

5歳1ヵ月男児。骨形成不全症の亜型のBruck症候群を有し、生下時より十数回の骨折歴があった。診断時からビスフォスホネート製剤のパミドロン酸二ナトリウム水和物を1ヵ月半ごとに静脈内投与した。口腔所見として齲蝕で抜歯・歯肉内療法を要する歯を多数認めた。2回の全身麻酔下歯科治療を行うこととなった。全身麻酔は1回目と2回目ともに同様の方法で行った。周術期を通して経皮的動脈血酸素飽和度、脈拍数の低下はみられず、デクスメデトミジン塩酸塩による呼吸抑制、循環抑制はみられなかった。RASSも抜管後から病棟に帰室するまで、2以下で推移し、興奮した状態は認めず、良好な鎮静状態が得られた。治療当日は入院したが、危惧された骨折もなく、経過良好であったため、翌日退院した。

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Perioperative management using dexmedetomidine for a pediatric patient with osteogenesis imperfecta undergoing dental treatment under general anesthesia

Hiroshi Tanimura, Hitoshi Higuchi, Kumiko Takaya, Ayaka Hirano, Shigeru Maeda, Yumiko Tomoyasu, Takuya Miyawaki

Journal of Japanese Dental Society of Anesthesiology 43 ( 1 ) 51 - 53 2015

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japanese Dental Society of Anesthesiology

Osteogenesis imperfecta (OS) is an autosomal recessive disease that results in a congenital vulnerability to external forces, easily leading to bone fractures. We performed dental treatment under general anesthesia in a pediatric patient with OS to prevent bone fractures induced by restraint during dental treatment, and the continuous infusion of dexmedetomidine was useful for controlling agitation after the general anesthesia. The patient was a 5-year-old male who had already experienced more than 10 bone fractures
he had been treated with intravenous injections of bisphosphonate every 45 days. General anesthesia for dental treatment was suggested by his parents and was performed twice for dental treatment and teeth extraction. The first and second general anesthesia procedures were performed using the same procedure: premedication with oral midazolam
induction with sevoflurane, remifentanil, and rocuronium
and maintenance with the continuous infusion of propofol and remifentanil. During the middle of the dental treatment procedure, a continuous infusion of 0.4 μg/kg/h of dexmedetomidine was started and continued until 30 minutes after the removal of the tracheal tube. The durations for the infusion of dexmedetomidine were 114 and 170 minutes in the first and second general anesthesia procedures, respectively. Abnormal respiratory and circulatory suppression related to the use of dexmedetomidine was not observed throughout the management period. An adequate level of sedation was obtained after emergence, with a Richmond Agitation-Sedation scale of 2 or less. Thus, the continuous infusion of dexmedetomidine was considered to be useful for preventing agitation after general anesthesia in a pediatric patient In the present case, this management procedure was useful for preventing bone fractures during the perioperative period in a patient with OS.

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知覚痛覚定量装置 (Pain Vision?) を応用した口腔内局所麻酔時の電流識別閾値評価 Reviewed

平野彩加, 本田優花, 川瀬明子, 丸濱美菜子, 友安弓子, 樋口仁, 前田茂, 宮脇卓也

岡山歯学会雑誌 33 ( 2 ) 19 - 21 2014.12

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：岡山歯学会

大学歯学部の教職員または学生で、研究参加に同意した健康な成人10名を被験者として、知覚痛覚定量分析装置と口腔用ディスポ電極を用い、リドカイン溶液を口腔内に注射した際の電流識別閾値を測定し、局所麻酔時の電流識別閾値を評価できるか検討した。測定値の再現性を確認するため、個体間変動、個体内変動および日内変動を調べた。電流識別閾値の個体間変動、個体内変動、日内変動における変動係数(CV)はほぼ10%未満であった。被験者10名の全てのリドカイン濃度(0%、0.25%、0.5%、1.0%、2.0%)において電流識別閾値の上昇量を算出し、リドカイン濃度別に平均した結果、対象間のばらつきはあるものの、同一対象ではリドカイン濃度が上がるにつれて、電流識別閾値の上昇量も上昇した。知覚痛覚定量分析装置と口腔用ディスポ電極を用いることで、局所麻酔時の電流識別閾値を評価できることが示唆された。

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岡山大学病院歯科麻酔科における過去10年間の麻酔管理症例の臨床統計

高谷久美子, 大西梨恵子, 兒玉茉莉, 谷村博史, 森恵, 本田優花, 平野彩加, 川瀬明子, 丸濱美菜子, 友安弓子, 樋口仁, 前田茂, 宮脇卓也

岡山歯学会雑誌 33 ( 2 ) 42 - 42 2014.12

Chronic Orofacial Pain in Dental Patients: Retrospective Investigation over 12 years Reviewed

Tomoyasu Yumiko, Higuchi Hitoshi, Mori Megumi, Takaya Kumiko, Honda Yuka, Yamane Ayaka, Yabuki Akiko, Hayashi Tomoko, Ishii-Maruhama Minako, Jinzenji Ayako, Maeda Shigeru, Kohjitani Atsushi, Shimada Masahiko, Miyawaki Takuya

Acta Medica Okayama 68 ( 5 ) 267 - 275 2014.10

歯科治療を受ける知的障害者に対してデクスメデトミジン塩酸塩経口投与による麻酔前投薬を行った１症例 Reviewed

平野彩加, 樋口仁, 兒玉茉莉, 友安弓子, 前田茂, 宮脇卓也

日本歯科麻酔学会雑誌 42 ( 5 ) 640 - 641 2014.10

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本歯科麻酔学会

症例は14歳男児で、自閉症、知的障害の既往があった。下顎臼歯部にう蝕を認め、静脈内鎮静下で歯科治療が予定された。11歳時の歯科治療の際に麻酔前投薬としてミダゾラム注射薬をジュースに混ぜて経口投与を試みたが、口を付けた直後に内服を拒否され難渋したことがあったため、麻酔前投与としてデクスメデトミジン塩酸塩をジュースに混ぜて内服させ、傾眠傾向となって酸素マスクを当てセボフルラン、酸素を吸入させた。意識消失後に静脈路を確保し、プロポフォールによる静脈内鎮静法を行った。術中に循環動態の変化はなく、処置終了と同時にプロポフォール投与を停止し、6分後に覚醒した。覚醒60分後、ふらつかずに歩行可能を確認して帰宅を許可した。

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Hemodynamic changes by drug interaction of adrenaline with chlorpromazine. Reviewed International journal

Hitoshi Higuchi, Akiko Yabuki, Minako Ishii-Maruhama, Yumiko Tomoyasu, Shigeru Maeda, Takuya Miyawaki

Anesthesia progress 61 ( 4 ) 150 - 154 2014.9

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

Adrenaline (epinephrine) is included in dental local anesthesia for the purpose of vasoconstriction. In Japan, adrenaline is contraindicated for use in patients receiving antipsychotic therapy, because the combination of adrenaline and an antipsychotic is considered to cause severe hypotension; however, there is insufficient evidence supporting this claim. The purpose of the present study was to clarify the changes in hemodynamics caused by drug interaction between adrenaline and an antipsychotic and to evaluate the safety of the combined use of adrenaline and an antipsychotic in an animal study. Male Sprague-Dawley rats were anesthetized with sodium pentobarbital. A catheter was inserted into the femoral artery to measure blood pressure and pulse rate. Rats were pretreated by intraperitoneal injection of chlorpromazine or chlorpromazine and propranolol, and after 20 minutes, saline or 1 of 3 different doses of adrenaline was administered by intraperitoneal injection. Changes in the ratio of mean arterial blood pressure and pulse rate were measured after the injection of adrenaline. Significant hypotension and tachycardia were observed after the injection of adrenaline in the chlorpromazine-pretreated rats. These effects were in a dose-dependent manner, and 100 μg/kg adrenaline induced significant hemodynamic changes. Furthermore, in the chlorpromazine and propranolol-pretreated rats, modest hypertension was induced by adrenaline, but hypotension and tachycardia were not significantly shown. Hypotension was caused by a drug interaction between adrenaline and chlorpromazine through the activation of the β-adrenergic receptor and showed a dose-dependent effect. Low-dose adrenaline similar to what might be used in human dental treatment did not result in a significant homodynamic change.

DOI： 10.2344/0003-3006-61.4.150

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抗凝固療法の再開に伴い術後出血を呈した深部静脈血栓症の既往を有する口腔外科患者の１症例 Reviewed

兒玉茉莉, 樋口仁, 山根彩加, 友安弓子, 丸濱美菜子, 矢吹明子, 本田優花, 前田茂, 宮脇卓也

日本歯科麻酔学会雑誌 42 ( 3 ) 299 - 300 2014.7

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本歯科麻酔学会

76歳男。口腔底の腫脹を主訴に受診した。左側口腔底癌の診断で、腫瘍切除術、下顎骨辺縁切除術および左側頸部郭清術を予定した。深部静脈血詮症を発症し、IVCフィルターが留置され、ワルファリンカリウム、アスピリンを服用していた。手術前から抗腫瘍薬TS-1の内服を開始したが、血小板数減少により1週間後に中止した。麻酔導入前から逐次型空気圧式マッサージ器を用いて間欠的空気圧迫法を行った。手術翌日にヘパリンの持続静脈内投与を再開した。顔面および頸部の腫脹が増加し、ヘパリンの投与を中止した。術後3日目には顔面および頸部の腫脹は改善傾向となった。術後4日目にヘパリンの投与を再開したが、口腔内創部より出血を認め、再度中止した。術後5日目にヘパリンの投与を再開し、出血、顔面および頸部の腫脹の増強は認めなかったため、ワルファリンカリウムの投与を追加した。術後経過のなかで呼吸・循環動態における問題は生じなかった。

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ゴールデンハー症候群３症例の口腔外科手術における挿管困難因子の検討 Reviewed

高谷久美子, 山根彩加, 林知子, 丸濱美菜子, 新井由起子, 友安弓子, 樋口仁, 前田茂, 宮脇卓也

日本歯科麻酔学会雑誌 42 ( 3 ) 301 - 302 2014.7

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本歯科麻酔学会

症例1は17歳男で、粘膜下口蓋裂および閉塞性睡眠時無呼吸症候群を合併し、下顎骨形成術を予定した。マッキントッシュ型喉頭鏡、ビデオ喉頭鏡で気管挿管を試みたが挿管できなかった。ビデオ咽頭鏡で気管チューブの位置を確認しながら気管支ファイバースコープを気管チューブの中に通して、気管支ファイバースコープをガイドとして気管挿管を行った。症例2は14歳女で、副耳、左側上肢先天性奇形、左側眼球白色病変を合併し、下顎骨形成術を予定した。マッキントッシュ型喉頭鏡、ビデオ喉頭鏡で気管挿管を試みたが挿管できなかった。気管支ファイバースコープを用いて試みても困難であったが、複数回試みた後に気管挿管できた。症例3は17歳男で、知的障害、心雑音、漏斗胸、口蓋裂、両外耳道閉塞を合併し、上顎骨形成術を予定した。マッキントッシュ型喉頭鏡は挿管困難であった。ビデオ喉頭鏡を用いて気管挿管できた。

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Locally injected dexmedetomidine induces vasoconstriction via peripheral α-2A adrenoceptor subtype in Guinea pigs Reviewed

Akiko Yabuki, Hitoshi, Higuchi, Tatsushi Yoshitomi, Yumiko Tomoyasu, Minako Ishii-Maruhama, Shigeru Maeda, Takuya Miyawaki

Regional Anesthesia and Pain Medicine 39 ( 2 ) 133 - 136 2014.4

歯科治療恐怖症患者に対してNoise-cancelling headphone(ノイズキャンセリングヘッドフォン)を併用した静脈内鎮静法を施行した1症例 Reviewed

丸濱美菜子, 樋口仁, 友安弓子, 高谷久美子, 森恵, 本田優花, 矢吹明子, 山根彩加, 前田茂, 宮脇卓也

日本歯科麻酔学会雑誌 42 ( 2 ) 218 - 219 2014.4

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本歯科麻酔学会

37歳女。前歯部審美修復を希望し、歯科治療恐怖症のためドルミカムおよびプロポフォール静脈内鎮静法下で歯科治療を計画した。計11回の静脈内鎮静法を施行し、歯科用タービン音などの聴覚刺激が加わらない治療では1.25mg/hg/hで良好な鎮静効果が得られたが、聴覚刺激が加わる治療では強い拒否反応を示し、プロポフォール投与量を3.12mg/kg/hまで増加しても緩和されなかった。耳栓装着では2.78gm/kg/hで効果がみられなかったため、ノイズキャンセリングヘッドフォンを装着してクラシック音楽を流し、ヘッドフォンに付随したマイクで主治医および歯科麻酔医の指示を必要時のみ聞こえるようにした結果、2.48mg/kg/hで歯科用タービンを用いた治療を予定通り行うことが可能であり、術後の患者の満足度も高かった。

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Locally injected dexmedetomidine inhibits carrageenin-induced inflammatory responses in the injected region Reviewed

Shintaro Sukegawa, Hitoshi Higuchi, Miho Inoue, Hitoshi Nagatsuka, Shigeru Maeda, Takuya Miyawaki

Anesthesia and Analgesia 118 ( 2 ) 473 - 480 2014.2

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND:: Dexmedetomidine, a highly selective agonist of α2-adrenoceptors, is a commonly used sedative; however, a potent anti-inflammatory effect has also been found. In the present study we evaluated the inhibitory effect of locally injected dexmedetomidine on inflammatory responses in the injected region. METHODS:: Local inflammation was induced in the hindpaws of male mice (aged 6-8 weeks) by intraplantar injection of lambda-carrageenin. To offset the central effect of tested agents, different agents were blindly injected into the left and right paws in the pairs of comparison. The effect of dexmedetomidine on edema (increase in paw volume), the accumulation of leukocytes, and production of tumor necrosis factor-α (TNF-α) and cyclooxygenase-2 (COX-2) were evaluated after carrageenin injection, using water displacement plethysmometry, histological imaging, immunohistochemistry, and Western blotting analysis. Furthermore, we also evaluated the effect of yohimbine, a full antagonist of α2-adrenoceptors, and phenylephrine, an agonist of the α1-adrenoceptor, on dexmedetomidine's action on inflammatory responses. RESULTS:: Paw volume and amount of leukocytes in the injected region significantly increased after the injection of carrageenin. Similarly, TNF-α and COX-2 production was found in the subcutaneous region injected with carrageenin, 4 hours after injection. Dexmedetomidine significantly inhibited all increases in paw volume, leukocytes, and production of TNF-α and COX-2. Furthermore, yohimbine significantly antagonized the anti-inflammatory effects of dexmedetomidine, whereas phenylephrine did not significantly alter them. CONCLUSIONS:: The findings suggest that locally injected dexmedetomidine exhibits an anti-inflammatory effect against local acute inflammatory responses, mediated by α2-adrenoceptors. © 2013 International Anesthesia Research Society.

DOI： 10.1213/ANE.0000000000000060

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A case of anesthetic premedication with oral dexmedetomidine to the dental patient with intellectual disability

Ayaka Hirano, Hitoshi Higuchi, Matsuri Kodama, Yumiko Tomoyasu, Shigeru Maeda, Takuya Miyawaki

Journal of Japanese Dental Society of Anesthesiology 42 ( 5 ) 640 - 641 2014

A case of the intravenous sedation with the noise-cancelling headphone for the patient with fear of dental treatments

Minako Maruhama, Hitoshi Higuchi, Yumiko Tomoyasu, Kumiko Takaya, Megumi Mori, Yuka Honda, Akiko Yabuki, Ayaka Yamane, Shigeru Maeda, Takuya Miyawaki

Journal of Japanese Dental Society of Anesthesiology 42 ( 2 ) 218 - 219 2014

The possible factors of difficult intubation in three cases with Goldenhar syndrome undergoing oral and maxillofacial surgery

Kumiko Takaya, Ayaka Yamane, Tomoko Hayashi, Minako Maruhama, Yukiko Arai, Yumiko Tomoyasu, Hitoshi Higuchi, Shigeru Maeda, Takuya Miyawaki

Journal of Japanese Dental Society of Anesthesiology 42 ( 3 ) 301 - 302 2014

A case of uncontrolled postoperative bleeding after oral surgery in a patient with deep venous thrombosis

Matsuri Kodama, Hitoshi Higuchi, Ayaka Yamane, Yumiko Tomoyasu, Minako Maruhama, Akiko Yabuki, Yuka Honda, Shigeru Maeda, Takuya Miyawaki

Journal of Japanese Dental Society of Anesthesiology 42 ( 3 ) 299 - 300 2014

A report of preoperative respiratory rehabilitation to patient with COPD undergoing oral and maxillofacial surgery

Megumi Mori, Hitoshi Higuchi, Yumiko Tomoyasu, Akiko Yabuki, Shigeru Maeda, Takuya Miyawaki

Journal of Japanese Dental Society of Anesthesiology 41 ( 5 ) 607 - 608 2013

A retrospective study on the risk factors for emergence agitation following general anesthesia

Yuka Honda, Shigeru Maeda, Hitoshi Higuchi, Yumiko Tomoyasu, Minako Ishii, Tomoko Hayashi, Kazuo Mukae, Ayaka Yamane, Akiko Yabuki, Takuya Miyawaki

Journal of Japanese Dental Society of Anesthesiology 41 ( 1 ) 21 - 25 2013

Language：Japanese Publishing type：Research paper (scientific journal)

We performed a retrospective study on the risk factors for emergence agitation following general anesthesia in patients undergoing oral surgery in Okayama University Hospital between June 2011 and March 2012. This study was performed after approval by the Ethics Committee of the Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences. One hundred and eighty one patients aged more than 16 years old were enrolled. We used the Richmond Agitation and Sedation Scale (RASS, Table 1), which was developed to assess the level of agitation and sedation following general anesthesia The patients were divided into two groups : non-agitated patients (RASS score : -5 to 0) and agitated patients (RASS score : 1 to 4). The results were statistically analyzed using JMP 9.0.0 (SAS Institute, Cary, USA). In the univariate analysis, Fisher's exact test and the χ2 test were used to compare groups. A multivariable analysis was performed using stepwise logistic regression to separately determine risk factors of agitation. Of the 181 patients, emergence agitation occurred in 30 patients (16.6%). Agitation of level 1, 2, 3 or 4 of excitement according to the RASS was observed in 25, 4, 1, and 0 patients, respectively. Table 2 shows the risk factors of emergence agitation using univariate analysis. Emergence agitation was not correlated with age, BMI, duration of operation, postoperative pain, amount of opioid during the operation, or kind of postoperative analgesics, but was more common in males than females (p = 0.039) and also in patients who received general anesthesia than patients who received total intravenous anesthesia (p = 0.011). Table 3 shows the risk factors of emergence agitation using multivariate analysis by stepwise logistic regression. One variable was associated with emergence agitation. Inhalational anesthesia was the highest risk factor (odds ratio [OR] = 3.24
95% confidence interval [CI] = 1.23-10.17
p = 0.015). In conclusion, the results suggest that inhalational anesthesia was the highest risk factor of emergence agitation.

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Midazolam is associated with delay in recovery and agitation after ambulatory general anesthesia for dental treatment in patients with disabilities: a retrospective cohort study. International journal

Shigeru Maeda, Yumiko Tomoyasu, Hitoshi Higuchi, Takayuki Mori, Masahiko Egusa, Takuya Miyawaki

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 70 ( 6 ) 1315 - 20 2012.6

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Some patients with intellectual disabilities (IDs) who undergo total intravenous anesthesia (TIVA) have complications associated with the anesthesia such as prolonged recovery. The purposes of this study were to estimate the frequency of TIVA complications among patients with IDs and to identify factors associated with TIVA complications. MATERIALS AND METHODS: This study was designed as a retrospective cohort study. Study samples were selected from the clinical records of patients with IDs who underwent ambulatory general anesthesia in a special dental clinic at the Okayama University Hospital, Okayama, Japan. Predictor variables were patient background, anesthesia-related variables, and dental treatment. Outcome variables were delayed recovery and the complication of agitation. Factors affecting delayed recovery and complications were examined with multivariable analysis. RESULTS: We enrolled 106 cases (81 male and 25 female patients) in this study. The mean age was 23.9 years. Serious complications were not observed in any cases. The amount of intravenous midazolam was an independent determinant of delayed recovery. Oral midazolam contributed to delayed recovery, although it is very useful for induction in patients with a high level of fear. Oral midazolam and a younger age were independent predictors of agitation. CONCLUSIONS: Intravenous midazolam may not have an advantage in ambulatory general anesthesia. Oral midazolam contributes to delayed recovery and is an independent predictor of agitation.

DOI： 10.1016/j.joms.2012.01.004

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