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OBATA Norihiko
Graduate School of Medicine / Faculty of Medical Sciences
Associate Professor

Researcher basic information

■ Research Areas
  • Life sciences / Anesthesiology

Research activity information

■ Paper
  • Kyohei Ueno, Yoshitetsu Oshiro, Shigeyuki Kan, Yuki Nomura, Hitoaki Satou, Norihiko Obata, Satoshi Mizobuchi
    BACKGROUND: Spinal cord stimulation (SCS) is widely accepted as a useful treatment for patients with intractable chronic pain. However, its effectiveness varies between individuals. Therefore, a tool for evaluating its effectiveness in advance is eagerly awaited. We examined whether resting-state functional magnetic resonance imaging as a diagnostic and prognostic tool can predict responsiveness to SCS. METHODS: Twenty-nine patients with intractable chronic pain participated in this study. Participants were divided into responder and non-responder groups based on a pain relief rate after SCS trials. All participants underwent resting-state functional magnetic resonance imaging scans before the SCS trials. We searched for functional connectivity that differed significantly in strength between the two groups and was correlated with pain relief rate. We conducted receiver operating characteristic (ROC) analysis and a one-sample proportion test to determine the cut-off value and evaluate the predictive power of the functional connectivity-based prediction model. RESULTS: In total, 14 and 15 participants were assigned to the responder and non-responder groups, respectively. Functional connectivity between the middle anterior cingulate cortex and precuneus/posterior cingulate cortex showed significant between-group differences and a significant negative correlation with the pain relief rate. Moreover, this functional connectivity could accurately predict SCS responsiveness greater than chance (sensitivity: 71%; specificity: 87%; area under the curve: 0.814; P<0.001). CONCLUSIONS: For patients with intractable chronic pain, functional connectivity between the middle anterior cingulate cortex and precuneus/posterior cingulate cortex is a promising candidate biomarker to estimate responsiveness to spinal cord stimulation before treatment.
    Nov. 2024, British journal of anaesthesia, English, International magazine
    Scientific journal

  • Takuya Kimura, Takuya Okada, Norihiko Obata, Yasushi Motoyama, Masaharu Nagae
    BACKGROUND: An aorto-caval fistula is a rare but critical complication of abdominal aortic aneurysm (AAA) rupture, leading to high-output heart failure and increased venous pressure. The anesthetic management of such cases, particularly when complicated by an intraoperative right-to-left shunt, is seldom reported. CASE PRESENTATION: A 71-year-old man with a history of atrial fibrillation and catheter ablation presented with heart failure and abdominal pain, leading to cardiac arrest. Imaging revealed an AAA rupture into the inferior vena cava. During emergency surgery, severe venous bleeding was managed using intra-aortic balloon occlusion (IABO). Transesophageal echocardiography (TEE) identified a right-to-left shunt due to an iatrogenic atrial septal defect. CONCLUSION: Early TEE recognition and timely IABO intervention were crucial in managing this complex case, underscoring the importance of these techniques in similar emergency scenarios.
    Aug. 2024, JA clinical reports, 10(1) (1), 50 - 50, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Shusuke Okamoto, Takuya Okada, Norihiko Obata, Masahiko Iseki, Yu Yamane, Masaharu Nagae
    Atypical aortic coarctation is an exceedingly rare condition, and there are very few reported cases of anesthetic management for bypass surgery in patients with severe impaired cardiac function. We present the anesthetic management of a 68-year-old woman with atypical aortic coarctation due to Takayasu arteritis and severely impaired cardiac function, who underwent ascending-to-abdominal aorta bypass surgery under extracorporeal membrane oxygenation (ECMO). The patient's severe cardiac dysfunction was due to sustained afterload from the coarctation, leading to recurrent episodes of heart failure. Surgical intervention was deemed necessary, and a decision was made to perform a bypass operation. The patient experienced a transient state of shock following induction of anesthesia, but subsequent perioperative care was safely managed with the implementation of ECMO. For bypass surgery performed on patients with severe cardiac dysfunction due to atypical coarctation of the aorta, it is crucial to prepare for potential circulatory collapse during anesthesia induction and the surgical procedure. This preparation includes meticulous planning of the anesthesia induction method and ensuring that ECMO can be established promptly if needed.
    Aug. 2024, Heliyon, 10(15) (15), e35605, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Daichi Fujimoto, Norihiko Obata, Satoshi Mizobuchi
    PURPOSE: Elderly patients with proximal femoral fractures are known to be a high-risk group for postoperative delirium (POD). The aim of this study was to determine the association of the benzodiazepine drug remimazolam with POD in elderly patients with proximal femoral fractures. METHODS: In this single-center retrospective observational study, we included patients aged 65 years or older who underwent general anesthesia for proximal femoral fractures. We collected data for the incidence of POD within 3 days after surgery. We also obtained data for complications, preoperative blood examinations, maintenance anesthetic and intraoperative vital data. The occurrence of POD in patients who received remimazolam for general anesthesia (remimazolam group) was compared to that in patients who received general anesthesia with other anesthetic agents (other group). We finally conducted a multivariate analysis to assess the independent association of remimazolam with the risk of POD. RESULTS: A total of 230 patients, including 54 patients who received remimazolam for maintenance anesthesia, were included in this study. The incidence of POD in the patients was 26.1%. The incidence of delirium within 3 days after surgery was significantly lower in the remimazolam group than in the other group (14.8% vs. 29.5%, p  =  0.03). The multivariate analysis showed that the use of remimazolam independently reduced the occurrence of POD (adjusted odds ratio  =  0.42, p  =  0.04). CONCLUSION: This retrospective observational study showed that the use of remimazolam is independently associated with a reduced incidence of POD. Remimazolam may be considered as an option to reduce POD in elderly patients with proximal femoral fractures.
    Aug. 2024, Journal of anesthesia, 38(4) (4), 475 - 482, English, Domestic magazine
    Scientific journal

  • Taishi Miyazaki, Shinya Taguchi, Norihiko Obata, Satoshi Mizobuchi
    BACKGROUND: Although 5-aminolevulinic acid is useful for the photodynamic diagnosis of bladder tumors, it often causes severe intraoperative hypotension. We report a case of postoperative cardiac arrest in addition to severe intraoperative hypotension, probably owing to the use of 5-aminolevulinic acid. CASE PRESENTATION: An 81-year-old Japanese man was scheduled to undergo transurethral resection of bladder tumor. The patient took 5-aminolevulinic acid orally 2 hours before entering the operating room. After the induction of anesthesia, his blood pressure decreased to 47/33 mmHg. The patient's hypotension did not improve even after noradrenaline was administered. After awakening from anesthesia, the patient's systolic blood pressure increased to approximately 100 mmHg, but approximately 5 hours after returning to the ward, cardiac arrest occurred for approximately 12 seconds. CONCLUSION: We experienced a case of postoperative cardiac arrest in a patient, probably owing to the use of 5-aminolevulinic acid. Although the cause of cardiac arrest is unknown, perioperative hemodynamic management must be carefully performed in patients taking 5-aminolevulinic acid.
    May 2024, Journal of medical case reports, 18(1) (1), 264 - 264, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Atsushi Miyazaki, Mai Hokka, Norihiko Obata, Satoshi Mizobuchi
    BACKGROUND: Various factors can cause vascular endothelial damage during cardiovascular surgery (CVS) with cardiopulmonary bypass (CPB), which has been suggested to be associated with postoperative complications. However, few studies have specifically investigated the relationship between the degree of vascular endothelial damage and postoperative acute kidney injury (pAKI). The objectives of this study were to measure perioperative serum syndecan-1 concentrations in patients who underwent CVS with CPB, evaluate their trends, and determine their association with pAKI. METHODS: This was a descriptive and case‒control study conducted at the National University Hospital. Adult patients who underwent CVS with CPB at a national university hospital between March 15, 2016, and August 31, 2020, were included. Patients who were undergoing preoperative dialysis, had preoperative serum creatinine concentrations greater than 2.0 mg dl-1, who were undergoing surgery involving the descending aorta were excluded. The perioperative serum syndecan-1 concentration was measured, and its association with pAKI was investigated. RESULTS: Fifty-two patients were included. pAKI occurred in 18 (34.6%) of those patients. The serum syndecan-1 concentration increased after CPB initiation and exhibited bimodal peak values. The serum syndecan-1 concentration at all time points was significantly elevated compared to that after the induction of anesthesia. The serum syndecan-1 concentration at 30 min after weaning from CPB and on postoperative day 1 was associated with the occurrence of pAKI (OR = 1.10 [1.01 to 1.21], P = 0.03]; OR = 1.16 [1.01 to 1.34], P = 0.04]; and the cutoff values of the serum syndecan-1 concentration that resulted in pAKI were 101.0 ng ml-1 (sensitivity = 0.71, specificity = 0.62, area under the curve (AUC) = 0.67 (0.51 to 0.83)) and 57.1 ng ml-1 (sensitivity = 0.82, specificity = 0.56, AUC = 0.71 (0.57 to 0.86)). Multivariate logistic regression analysis revealed that the serum syndecan-1 concentration on postoperative day 1 was associated with the occurrence of pAKI (OR = 1.02 [1.00 to 1.03]; P = 0.03). CONCLUSION: The serum syndecan-1 concentration at all time points was significantly greater than that after the induction of anesthesia. The serum syndecan-1 concentration on postoperative day 1 was significantly associated with the occurrence of pAKI. TRIAL REGISTRATION: This study is not a clinical trial and is not registered with the registry.
    Apr. 2024, BMC anesthesiology, 24(1) (1), 154 - 154, English, International magazine
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Norihiko Obata, Eri Nakai, Shohei Makino, Satoshi Mizobuchi
    We describe the perioperative management of a pregnant woman with severe needle phobia who underwent a cesarean section. General anesthesia with slow induction using an inhalant anesthetic for cesarean section is a rare and unique situation. Furthermore, the management of this case was more complicated because the patient not only refused the puncture procedure but also refused the presence of an indwelling object when she woke up from the anesthesia. After the operation, the patient was admitted to the intensive care unit (ICU) and received mechanical ventilation under deep sedation. The patient was managed under sedation until the day after surgery, and both mother and child progressed without perioperative complications.
    Apr. 2024, Cureus, 16(4) (4), e59032, English, International magazine
    Link to Kobe Univ. Repository (Kernel)

  • Kyohei Ueno, Hitoaki Sato, Yuki Nomura, Norihiko Obata, Satoshi Mizobuchi
    OBJECTIVE: Patients with chronic pain often have sleep disturbances, and many patients receive sleep medications in addition to analgesics. Although there have been scattered reports of negative pain-sleep interactions, only a few reports have investigated the efficacy of sleep medication interventions in patients with chronic pain for improving sleep disturbances and reducing pain. We retrospectively examined whether lemborexant, an orexin receptor antagonist, is effective in improving sleep disturbances and reducing pain in patients with chronic pain. This study was approved by the Ethics Committee of our hospital. METHODS: The subjects were 26 patients with chronic pain undergoing treatment at our pain clinic between July 2021 and March 2022, who had been diagnosed with insomnia, with an Athens Insomnia Scale (AIS) score of ≥6 and had been started on lemborexant. The AIS score and pain score (Numeric Rating Scale [NRS]) before and after 2 and 4 weeks of starting lemborexant were investigated. RESULTS: Patients who were already taking other sleep medications, such as benzodiazepines were switched to 5 mg of lemborexant after all the other sleep medications were discontinued. Those who had not yet used sleeping pills were started on 5 mg of lemborexant. During the study course, the dose of lemborexant was adjusted at the discretion of the attending physician, based on improvement of insomnia symptoms and secondary symptoms, such as daytime sleepiness and lightheadedness. The study finally included 21 patients, excluding 5 who could not continue taking lemborexant due to side effects, such as lightheadedness. The AIS scores significantly improved, decreasing from baseline (mean ± standard deviation: 12.5 ± 4.9) to 2 weeks (7.8 ± 3.1) and 4 weeks (5.3 ± 2.9) after the start of lemborexant. No significant difference was observed in the degree of improvement in sleep disturbance between patients with or without previous sleep medications, and there was also no statistically significant improvement in the NRS score before (6.1 ± 2.7) and after 2 weeks (5.5 ± 2.3) and 4 weeks (5.9 ± 2.2) from treatment initiation.
    Feb. 2024, Pain medicine (Malden, Mass.), 25(2) (2), 139 - 143, English, International magazine
    Scientific journal

  • Shusuke Okamoto, Takuya Okada, Norihiko Obata, Yu Yamane, Koichiro Masada, Masahiko Iseki, Masaharu Nagae
    We report a case involving anesthetic management of Stanford type B acute aortic dissection occurred during transcatheter aortic valve implantation (TAVI) under monitored anesthesia care (MAC) in a patient with aortic stenosis (AS). An 87-year-old woman was undergoing TAVI under MAC for severe AS. During the surgery, the patient suddenly moved possibly because of pain. This was followed by hemodynamic collapse. She was then transitioned to general anesthesia, and extracorporeal membrane oxygenation (ECMO) was initiated. Transesophageal echocardiography revealed a Stanford type B acute aortic dissection, which was safely managed perioperatively with appropriate interventions.
    Nov. 2023, Heliyon, 9(11) (11), e21278, English, International magazine

  • Yasushi Motoyama, Hitoaki Sato, Yuki Nomura, Norihiko Obata, Satoshi Mizobuchi
    We report a successful case of fluoroscopic percutaneous retrocrural coeliac plexus neurolysis (PRCPN) for pancreatic cancer pain refractory to endoscopic ultrasound-guided coeliac plexus neurolysis (EUS-CPN). A 55-year-old man with upper abdominal pain due to end-stage pancreatic cancer underwent EUS-CPN. Although CT revealed distribution of the contrast medium with neurolytic agent around the left and cephalic sides of the coeliac artery, the pain did not improve and became even more severe. PRCPN was performed, resulting in the drastic improvement of pain immediately. PRCPN should be considered when EUS-CPN is not effective.
    BMJ, Oct. 2023, BMJ supportive & palliative care, 13(e1) (e1), e81-e83 - 2020, English, International magazine
    Scientific journal

  • Shinya Taguchi, Daichi Fujimoto, Moe Shiga, Norihiko Obata, Satoshi Mizobuchi
    The neuromuscular blocking potency of rocuronium varies with respiratory pH changes, increasing at lower pH and decreasing at higher pH; thus, hyperventilation-induced respiratory alkalosis is expected to decrease the potency of rocuronium. We report a case of anesthetic management of modified electroconvulsive therapy (m-ECT) for a patient monitored with electromyography-based neuromuscular monitoring during two patterns of ventilation to elucidate their relationship and propose the possible mechanisms underlying the effects by computational simulations. Case presentation: The patient was a 25-year-old man with schizophrenia. In m-ECT, hyperventilation may be used to produce longer seizures. We compared the neuromuscular monitoring data recorded during hyperventilation and during normal ventilation while receiving the same dose of rocuronium. Despite receiving the same dose of rocuronium, the time required for the first twitch to decrease to 80% of the control value was delayed in hyperventilation compared to normal ventilation. Conclusions: This case report and computational simulation suggest that respiratory alkalosis might delay the action of rocuronium. It is necessary to consider the delayed action of rocuronium when hyperventilation is performed.
    Aug. 2023, Journal of clinical monitoring and computing, 37(4) (4), 1115 - 1118, English, International magazine
    Scientific journal

  • A Case of a Highly Obese Covid-19 Patient with Severe Hypoxemia and Subcutaneous Mediastinal Emphysema Who Was Rescued by Early Introduction of ECMO.
    Shuhei Takahashi, Norihiko Obata, Shohei Makino, Nana Furushima, Taichi Nishimura, Satoshi Mizobuchi
    We conducted the treatment of a highly obese patient with severe Covid-19 pneumonia who had a history of asthma. When she arrived at the hospital, she was already intubated and had mediastinal emphysema and severe hypoxemia. Because the patient's condition did not improve with mechanical ventilation, we introduced extracorporeal membrane oxygenation (ECMO) immediately after admission. The patient improved with early induction of ECMO and prone positioning. In the management of patients with severe Covid-19 pneumonia, early introduction of ECMO should be considered if oxygenation does not improve with mechanical ventilation, and prone positioning can also be effective.
    Jul. 2023, The Kobe journal of medical sciences, 69(2) (2), E49-E51, English, Domestic magazine
    Scientific journal

  • Kenji Yoshitani, Soshiro Ogata, Shinya Kato, Akito Tsukinaga, Tsunenori Takatani, Nobuhide Kin, Mariko Ezaka, Jun Shimizu, Yuko Furuichi, Shoichi Uezono, Kotaro Kida, Katsuhiro Seo, Shinichi Kakumoto, Hiroshi Miyawaki, Mikito Kawamata, Satoshi Tanaka, Manabu Kakinohana, Shunsuke Izumi, Hiroyuki Uchino, Takayasu Kakinuma, Kimitoshi Nishiwaki, Kazuko Hasegawa, Mishiya Matsumoto, Kazuyoshi Ishida, Atsuo Yamashita, Michiaki Yamakage, Yusuke Yoshikawa, Yuji Morimoto, Hitoshi Saito, Takahisa Goto, Tetsuhito Masubuchi, Masahiko Kawaguchi, Kosuke Tsubaki, Satoshi Mizobuchi, Norihiko Obata, Yoshimi Inagaki, Kazumi Funaki, Yoshiki Ishiguro, Masamitsu Sanui, Kazutaka Taniguchi, Kunihiro Nishimura, Yoshihiko Ohnishi
    PURPOSE: Cerebrospinal fluid drainage (CSFD) is recommended during open or endovascular thoracic aortic repair. However, the incidence of CSFD complications is still high. Recently, CSF pressure has been kept high to avoid complications, but the efficacy of CSFD at higher pressures has not been confirmed. We hypothesize that CSFD at higher pressures is effective for preventing motor deficits. METHODS: This prospective observational study included 14 hospitals that are members of the Japanese Society of Cardiovascular Anesthesiologists. Patients who underwent thoracic and thoracoabdominal aortic repair were divided into four groups: Group 1, CSF pressure around 10 mmHg; Group 2, CSF pressure around 15 mmHg; Group 3, CSFD initiated when motor evoked potential amplitudes decreased; and Group 4, no CSFD. We assessed the association between the CSFD group and motor deficits using mixed-effects logistic regression with a random intercept for the institution. RESULTS: Of 1072 patients in the study, 84 patients (open surgery, 51; thoracic endovascular aortic repair, 33) had motor deficits at discharge. Groups 1 and 2 were not associated with motor deficits (Group 1, odds ratio (OR): 1.53, 95% confidence interval (95% CI): 0.71-3.29, p = 0.276; Group 2, OR: 1.73, 95% CI: 0.62-4.82) when compared with Group 4. Group 3 was significantly more prone to motor deficits than Group 4 (OR: 2.56, 95% CI: 1.27-5.17, p = 0.009). CONCLUSION: CSFD is not associated with motor deficits in thoracic and thoracoabdominal aortic repair with CSF pressure around 10 or 15 mmHg.
    Jun. 2023, Journal of anesthesia, 37(3) (3), 408 - 415, English, Domestic magazine
    Scientific journal

  • Masahiro Ushio, Moritoki Egi, Daichi Fujimoto, Norihiko Obata, Satoshi Mizobuchi
    OBJECTIVES: To study the timing, threshold, and duration of intraoperative hypotension (IOH) associated with the risk of postoperative delirium (POD). DESIGN: A single-center retrospective observational study. SETTING: University teaching hospital. PARTICIPANTS: A total of 503 adult patients who underwent cardiac valvular surgery that required cardiopulmonary bypass (CPB). MEASUREMENTS AND MAIN RESULTS: The authors predefined the following 4 periods: (1) during surgery, (2) pre-CPB, (3) during CPB, and (4) post-CPB, and 8 thresholds of mean arterial pressure for IOH according to every 5 mmHg between 50 mmHg and 85 mmHg. The authors calculated the cumulative duration below the 8 thresholds in each period. The primary outcome was delirium defined as a score of ≥4 for at least one Intensive Care Delirium Screening Checklist assessment during 48 h after the surgery. Among 503 patients, POD occurred in 95 patients (18.9%). There was no significant association of POD with all of the thresholds of IOH in the periods of pre-CPB, during CPB, and during surgery. However, in the post-CPB period, the patients with POD had a significantly longer cumulative duration of IOH according to all of the thresholds of mean arterial pressure. In multivariate analyses, 4 IOH thresholds in the post-CPB period were associated independently with POD: <60 mmHg (odds ratio [OR] =1.84 [95% CI 1.10-3.10]), <65 mmHg (OR = 1.72 [1.01-2.92]), <70 mmHg (OR = 1.83 [1.03-3.26]), and <75 mmHg (OR = 1.94 [1.02-3.69]). CONCLUSIONS: A longer cumulative duration of IOH with the threshold between <60 and <75 mmHg that occurred after CPB was independently associated with the risk of POD.
    Nov. 2022, Journal of cardiothoracic and vascular anesthesia, 36(11) (11), 4062 - 4069, English, International magazine
    Scientific journal

  • Nana Furushima, Moritoki Egi, Norihiko Obata, Hitoaki Sato, Satoshi Mizobuchi
    PURPOSE: To apply continuous glucose monitoring (CGM) and determine the mean amplitude of glycemic excursions (MAGE) in septic patients and to assess the associations of MAGE with outcomes and oxidative stress. MATERIALS AND METHODS: This study was conducted in adult septic patients expected to require intensive care for >48 h. We continuously measured blood glucose level for the first 48 h in the ICU using FreeStyle Libre®. MAGE was calculated using glycemic information obtained by CGM during the study period of 48 h. The primary outcome was 90-day all-cause mortality. The secondary outcomes were 90-day ICU-free days and the concentration of urinary 8-isoprostaglandinF2α measured 48 h after commencement of the study as a surrogate of oxidative stress. RESULTS: Forty patients were included in this study. Median of MAGE was higher in non-survivors than in survivors: 68.8 (IQR;39.7-97.2) vs. 39.3 (IQR;19.9-53.3), p = 0.02. In multivariate analysis, MAGE was independently associated with 90-day all-cause mortality rate (p = 0.02), urinary 8-isoprostaglandinF2α level (p = 0.03) and 90-day ICU-free survival days (p = 0.03). CONCLUSIONS: In the current study, MAGE for the first 48 h of treatment that was obtained by using CGM was associated with 90-day all-cause mortality, 90-day ICU-free days and urinary 8-isoprostaglandinF2α level in septic patients.
    Jun. 2021, Journal of critical care, 63, 218 - 222, English, International magazine
    Scientific journal

  • Takuya Okada, Daisuke Kato, Yuki Nomura, Norihiko Obata, Xiangyu Quan, Akihito Morinaga, Hajime Yano, Zhongtian Guo, Yuki Aoyama, Yoshihisa Tachibana, Andrew J Moorhouse, Osamu Matoba, Tetsuya Takiguchi, Satoshi Mizobuchi, Hiroaki Wake
    Sustained neuropathic pain from injury or inflammation remains a major burden for society. Rodent pain models have informed some cellular mechanisms increasing neuronal excitability within the spinal cord and primary somatosensory cortex (S1), but how activity patterns within these circuits change during pain remains unclear. We have applied multiphoton in vivo imaging and holographic stimulation to examine single S1 neuron activity patterns and connectivity during sustained pain. Following pain induction, there is an increase in synchronized neuronal activity and connectivity within S1, indicating the formation of pain circuits. Artificially increasing neuronal activity and synchrony using DREADDs reduced pain thresholds. The expression of N-type voltage-dependent Ca2+ channel subunits in S1 was increased after pain induction, and locally blocking these channels reduced both the synchrony and allodynia associated with inflammatory pain. Targeting these S1 pain circuits, via inhibiting N-type Ca2+ channels or other approaches, may provide ways to reduce inflammatory pain.
    Mar. 2021, Science advances, 7(12) (12), English, International magazine
    [Refereed]
    Scientific journal

  • Continuous Mandibular Nerve Block for Intractable Mandibular Pain Due to Antiresorptive Agent-Related Osteonecrosis of the Jaw: A Case Report.
    Daichi Fujimoto, Norihiko Obata, Yasushi Motoyama, Hitoaki Sato, Yumiko Takao, Satoshi Mizobuchi
    Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) causes severe pain that cannot be controlled well by common analgesic drugs. This is a first case report of intractable mandibular pain due to ARONJ that was eliminated by a continuous mandibular nerve block. A 72-year-old woman with osteoporosis had been administered bisphosphonate. One year after extraction of her tooth, she was diagnosed as having ARONJ. Jaw pain was so severe that she was unable to open her mouth and eat. We performed a continuous mandibular nerve block through an indwelling catheter with levobupivacaine for pain management. After the procedure, her rest pain was markedly improved, and the pain induced by opening her mouth disappeared. We conclude that a continuous mandibular nerve block may be helpful in the management of ARONJ.
    Nov. 2020, The Kobe journal of medical sciences, 66(3) (3), E90-E93, English, Domestic magazine
    Scientific journal

  • Daichi Fujimoto, Yuki Nomura, Moritoki Egi, Norihiko Obata, Satoshi Mizobuchi
    BACKGROUND: The risk of surgical site infection has been reported to be higher in patients with poorly controlled diabetes. Since chronic hyperglycemia impairs neutrophil functions, preoperative glycemic control may restore neutrophil function. However, long-term insulin therapy may lead to a delay in surgery, which may be a problem, especially in cancer surgery. It is therefore unfortunate that there have been few studies in which the optimal duration of perioperative glycemic control for diabetes with chronic hyperglycemia was investigated. Therefore, we investigated the effects of preoperative long-term insulin therapy and short-term insulin therapy on perioperative neutrophil functions in diabetic mice with chronic hyperglycemia. METHODS: Five-week-old male C57BL/6 J mice were divided into four groups (No insulin (Diabetes Mellitus: DM), Short-term insulin (DM), Long-term insulin (DM), and Non-diabetic groups). Diabetes was established by administrating repeated low-dose streptozotocin. The Short-term insulin (DM) group received insulin therapy for 6 h before the operation and the Long-term insulin (DM) group received insulin therapy for 5 days before the operation. The No insulin (DM) group and the Non-diabetic group did not receive insulin therapy. At 14 weeks of age, abdominal surgery with intestinal manipulation was performed in all four groups. We carried out a phagocytosis assay with fluorescent microspheres and a reactive oxygen species (ROS) production assay with DCFH-DA (2',7'-dichlorodihydrofluorescein diacetate) before and 24 h after the operation using FACSVerse™ with BD FACSuite™ software. RESULTS: Blood glucose was lowered by insulin therapy in the Short-term insulin (DM) and Long-term insulin (DM) groups before the operation. Neutrophilic phagocytosis activities before and after the operation were significantly restored in the Long-term insulin (DM) group compared with those in the No insulin (DM) group (before: p = 0.0008, after: p = 0.0005). However, they were not significantly restored in the Short-term insulin (DM) group. Neutrophilic ROS production activities before and after the operation were not restored in either the Short-term insulin (DM) group or Long-term insulin (DM) group. CONCLUSIONS: Preoperative and postoperative phagocytosis activities are restored by insulin therapy for 5 days before the operation but not by insulin therapy for 6 h before the operation.
    Sep. 2020, BMC endocrine disorders, 20(1) (1), 146 - 146, English, International magazine
    Scientific journal

  • Momoka Nishimura, Yuki Nomura, Moritoki Egi, Norihiko Obata, Makoto Tsunoda, Satoshi Mizobuchi
    BACKGROUND: There has been much discussion recently about the occurrence of neuropsychological complications during the perioperative period. Diabetes is known to be one of the metabolic risk factors. Although the number of patients with diabetes mellitus (DM) has been increasing, the pathophysiology of postoperative neuropsychological dysfunction in DM patients is still unclear. Recently, a deficiency of neurotransmitters, such as monoamines, was reported to be associated with mental disorders. Therefore, we investigated the effects of surgical stress on behavioral activity and hippocampal noradrenaline (NA) level in type 2 diabetes mellitus model (T2DM) mice. METHODS: Eighty-four 6-week-old male C57BL/6J mice were divided into four groups (non-diabetes, non-diabetes with surgery, T2DM, and T2DM with surgery groups). T2DM mice were established by feeding a high-fat diet (HFD) for 8 weeks. At 14 weeks of age, fifteen mice in each group underwent a series of behavioral tests including an open field (OF) test, a novel object recognition (NOR) test and a light-dark (LD) test. In the surgery groups, open abdominal surgery with manipulation of the intestine was performed 24 h before the behavioral tests as a surgical stress. Hippocampal noradrenaline (NA) concentration was examined in six mice in each group by high-performance liquid chromatography. The data were analyzed by the Mann-Whitney U test, and p values less than 0.05 were considered significant. RESULTS: The T2DM group showed significantly increased explorative activity in the NOR test (P = 0.0016) and significantly increased frequency of transition in the LD test (P = 0.043) compared with those in the non-diabetic group before surgery. In T2DM mice, surgical stress resulted in decreased total distance in the OF test, decreased explorative activity in the NOR test, and decreased frequency of transition in the LD test (OF: P = 0.015, NOR: P = 0.009, LD: P = 0.007) and decreased hippocampal NA (P = 0.015), but such differences were not observed in the non-diabetic mice. CONCLUSIONS: Mice with T2DM induced by feeding an HFD showed increased behavioral activities, and surgical stress in T2DM mice caused postoperative hypoactivity and reduction of the hippocampal NA level.
    Feb. 2020, BMC neuroscience, 21(1) (1), 8 - 8, English, International magazine
    [Refereed]
    Scientific journal

  • Riho Nakayama, Takuya Yoshida, Norihiko Obata, Satoshi Mizobuchi
    BACKGROUND: Modified electroconvulsive therapy (m-ECT) is utilized worldwide as an effective treatment for drug-resistant psychiatric disorders. However, during m-ECT, treatment of hypotension and hypertension in response to rapid hemodynamic changes is required. We used noninvasive continuous blood pressure monitoring system for continuous hemodynamic measurement during m-ECT. CASE PRESENTATION: The patient was a 77-year-old man with depression complicated by coronary artery aneurysms (CAAs). We managed general anesthesia during m-ECT by using the ClearSight™ system (Edwards Lifesciences Corp, Irvine, CA, USA) for hemodynamic measurement. As a result, we performed a total of 10 m-ECTs. No rupture of CAAs or myocardial ischemia occurred and depressive symptoms improved. CONCLUSION: We successfully managed the anesthesia in m-ECT for a depressed patient with CAAs without complications by using the ClearSight™ system, which was used for the effective management of circulatory fluctuations.
    Nov. 2019, JA clinical reports, 5(1) (1), 76 - 76, English, International magazine
    [Refereed]
    Scientific journal

  • Anesthetic Management of Transcatheter Aortic Valve Replacement under Extracorporeal Membrane Oxygenation in a Patient with Acute Decompensated Heart Failure: A Case Report.
    Takuya Okada, Takuya Yoshida, Shohei Makino, Norihiko Obata, Satoshi Mizobuchi
    We managed general anesthesia for transcatheter aortic valve replacement (TAVR) under elective extracorporeal membrane oxygenation (ECMO) in a patient with aortic valve stenosis (AS) complicated with acute decompensated heart failure. The patient was an 87-year-old woman with acute heart failure due to severe AS who had been hospitalized. However, her low cardiac output did not improve, and weaned her off catecholamines was difficult, so semi-urgent TAVR was performed. Due to her acute decompensated heart failure complicated by low-left ventricular function, we decided electively to use ECMO for transfemoral TAVR to prevent hemodynamic collapse during induction of anesthesia and surgery, enabling the safe perioperative management of this patient under general anesthesia.
    Nov. 2019, The Kobe journal of medical sciences, 65(3) (3), E90-E94, English, Domestic magazine
    [Refereed]
    Scientific journal

  • Yasushi Motoyama, Yoshitetsu Oshiro, Yumiko Takao, Hitoaki Sato, Norihiko Obata, Shinichiro Izuta, Satoshi Mizobuchi, Shigeyuki Kan
    Ketamine has been used to treat chronic pain; however, it is still unknown as to what types of chronic pain is ketamine effective against. To identify the effect of administration of subanesthetic-dose ketamine in patients with chronic pain and to clarify the mechanism of the effect, we retrospectively investigated brain functional connectivity using resting-state functional magnetic resonance imaging (rs-fMRI). Patients were divided into responders (Group R: ≥50% improvement on Numerical Rating Scale) and non-responders (Group NR). We compared the differences in terms of brain functional connectivity by seed-to-voxel correlation analysis. Two-sample t-test revealed significant lower connectivity between the medial prefrontal cortex (mPFC) and precuneus in Group R. We also found a significant negative correlation between the improvement rate and functional connectivity strength between the mPFC and precuneus. These findings suggest that subanesthetic-dose ketamine is effective in patients with chronic pain whose brain functional connectivity between the mPFC and precuneus is low. We believe that the current study explored for the first time the correlation between brain functional connectivity and the effect of subanesthetic-dose ketamine for chronic pain and indicated the possibility of use of the predictive marker in pharmacological treatment of chronic pain.
    Sep. 2019, Scientific reports, 9(1) (1), 12912 - 12912, English, International magazine
    [Refereed]
    Scientific journal

  • Yoichiro Sugizaki, Shumpei Mori, Yuichi Nagamatsu, Tomomi Akita, Akira Nagasawa, Takayoshi Toba, Masatsugu Yamamoto, Tatsuya Nishii, Norihiko Obata, Yoshikatsu Nomura, Hiromasa Otake, Toshiro Shinke, Yutaka Okita, Ken-Ichi Hirata
    An 82-year-old man with severe aortic stenosis and idiopathic pulmonary fibrosis (IPF) underwent transcatheter aortic valve implantation (TAVI) under general anesthesia. However, following a successful TAVI procedure, he developed progressive respiratory failure because of the exacerbation of IPF. Despite the use of immunosuppressants, the patient could not be saved and he died of respiratory failure. Although TAVI is a less invasive procedure compared to conventional surgical aortic valve replacement, it is currently selected for management of severely ill, frail, and elderly patients. This case highlights the potential risk of IPF exacerbation following a TAVI procedure performed under general anesthesia. .
    Nov. 2018, Journal of cardiology cases, 18(5) (5), 171 - 174, English, Domestic magazine
    [Refereed]
    Scientific journal

  • Yuuki Nishihara, Takuya Yoshida, Mayu Ooi, Norihiko Obata, Shinichiro Izuta, Satoshi Mizobuchi
    AIM: To investigate the anesthetic management of peroral endoscopic myotomy (POEM) and its associated complications. METHODS: This study was a single-center, retrospective, observational study comprising a case series of all patients who underwent POEM in our hospital from April 2015 to November 2016. We collected data regarding patient characteristics, anesthetic methods, surgical factors, and complications using an electronic chart. RESULTS: There were 86 patients who underwent POEM in our hospital during the study period. Preoperatively, patients were maintained on a low residue diet for 48 h prior to the procedure. They were fasted of solids for 24 h before surgery. There was one case of aspiration (1.2%). During POEM, patients were positioned supine with the upper abdomen covered by a clear drape so that pneumoperitoneum could be timeously identified. In three cases, the peak airway pressure exceeded 35 cmH2O during volume controlled ventilation with tidal volumes of 6-8 mL/kg and subsequent impairment of ventilation. These cases had been diagnosed with spastic esophageal disorders (SEDs) and the length of the muscular incision on the esophageal side was longer than normal. CONCLUSION: In the anesthetic management of POEM, it is important to prevent aspiration during induction of anesthesia and to identify and treat complications associated with CO2 insufflation.
    Sep. 2018, World journal of gastrointestinal endoscopy, 10(9) (9), 193 - 199, English, International magazine
    [Refereed]
    Scientific journal
    Link to Kobe Univ. Repository (Kernel)

  • Masahiro Ushio, Moritoki Egi, Junji Wakabayashi, Taichi Nishimura, Yuji Miyatake, Norihiko Obata, Satoshi Mizobuchi
    Dec. 2016, Journal of cardiothoracic and vascular anesthesia, 30(6) (6), 1454 - 1460, English, International magazine
    [Refereed]
    Scientific journal

  • [Vital Sign Changes and the Requirement of Analgesics after Discontinuation of Dexmedetomidine in Patients after Esophageal Cancer Surgery.].
    Daichi Fujimoto, Moritoki Egi, Norihiko Obata, Shinichiro Izuta, Satoshi Mizobuchi
    BACKGROUND: There is few study to examine the vital sign changes and the requirement of analgesics after discontinuation of dexmedetomidine in postopera- tive patients. METHODS: This is a retrospective observational study conducted in 74 patients after esophageal cancer sur- gery. We recorded vital signs including blood pressure, heart rate and respiratory rate one hour before discon- tinuation of dexmedetomidine, and at 1, 2, 4, 6 hours after its discontinuation. We also recorded the use of opioid and analgesic within 6 hours after discontinua- tion. RESULTS: Mean blood pressure, pulse rate, and respi- ratory rate significantly increased after DEX discon- tinuation. Compared with the data before discontinua- tion, the mean blood pressure increased by 13.3 mmHg, heart rate increased by 7.5 beats - min- and respira- tory rate increased by 3.0 times - min-' in average at 6 hours after discontinuation. There were 28 patients (38%) who required the additional analgesics within 6 hours after discontinuation. CONCLUSIONS: After discontinuation of dexmedetomi- dine, significant changes of vital signs, especially in mean blood pressure, were observed in post-esopha- gectomy patients. About 38% of them required addi- tional analgesics within 6 hours after dexmedetomidine discontinuation.
    Sep. 2016, Masui. The Japanese journal of anesthesiology, 65(8) (8), 795 - 800, Japanese, Domestic magazine
    [Refereed]
    Scientific journal

  • Naoto Tomotsuka, Ryuji Kaku, Norihiko Obata, Yoshikazu Matsuoka, Hirotaka Kanzaki, Arata Taniguchi, Noriko Muto, Hiroki Omiya, Yoshitaro Itano, Tadasu Sato, Hiroyuki Ichikawa, Satoshi Mizobuchi, Hiroshi Morimatsu
    2014, Journal of pain research, 7, 415 - 23, English, International magazine
    [Refereed]
    Scientific journal

  • Satoshi Mizobuchi, Hirotaka Kanzaki, Hiroki Omiya, Yoshikazu Matsuoka, Norihiko Obata, Ryuji Kaku, Hirochika Nakajima, Mamoru Ouchida, Kiyoshi Morita
    2013, Journal of pain research, 6, 87 - 94, English, International magazine
    [Refereed]
    Scientific journal

  • Hirotaka Kanzaki, Satoshi Mizobuchi, Norihiko Obata, Yoshitaro Itano, Ryuji Kaku, Naoto Tomotsuka, Hirochika Nakajima, Mamoru Ouchida, Hideki Nakatsuka, Kyoichiro Maeshima, Kiyoshi Morita
    Feb. 2012, Neuroscience letters, 508(2) (2), 78 - 83, English, International magazine
    [Refereed]
    Scientific journal

  • Antinociceptive effects of intrathecal landiolol injection in a rat formalin pain model.
    Satoshi Mizobuchi, Yoshikazu Matsuoka, Norihiko Obata, Ryuji Kaku, Yoshitaro Itano, Naoto Tomotsuka, Arata Taniguchi, Hiroyuki Nishie, Hirotaka Kanzaki, Mamoru Ouchida, Kiyoshi Morita
    Jun. 2012, Acta medica Okayama, 66(3) (3), 285 - 9, English, Domestic magazine
    [Refereed]
    Scientific journal

  • Norihiko Obata, Satoshi Mizobuchi, Yoshitaro Itano, Yoshikazu Matsuoka, Ryuji Kaku, Naoto Tomotsuka, Kiyoshi Morita, Hirotaka Kanzaki, Mamoru Ouchida, Masataka Yokoyama
    Apr. 2011, Biochemical and biophysical research communications, 408(1) (1), 139 - 44, English, International magazine
    [Refereed]
    Scientific journal

■ MISC
■ Books And Other Publications
  • 麻酔偶発症 A to Z / 脂肪塞栓症
    Obata Norihiko, 溝渕知司
    Others, 文光堂, Jun. 2017, Japanese
    Scholarly book

■ Lectures, oral presentations, etc.
  • 人工呼吸管理中のCOVID-19患者に対するセボフルランの使用経験
    宮崎 純志, 西村 太一, 巻野 将平, 牛尾 将洋, 小幡 典彦, 溝渕 知司
    日本集中治療医学会雑誌, Jun. 2023, Japanese, (一社)日本集中治療医学会

  • 肺高血圧患者の麻酔・周術期管理において留意すべき点
    小幡 典彦
    日本肺高血圧・肺循環学会学術集会抄録集, Jun. 2023, Japanese, 日本肺高血圧・肺循環学会

  • 当院における脊髄性筋萎縮症成人例に対するヌシネルセン使用経験
    大塚 喜久, 橋本 黎, 荒木 健, 中野 孝宏, 的場 健人, 渡部 俊介, 辻 佑木生, 立花 久嗣, 千原 典夫, 上田 健博, 永井 正志, 粟野 宏之, 小幡 典彦, 関口 兼司
    臨床神経学, Nov. 2019, Japanese, (一社)日本神経学会

  • 大脳皮質感覚野の生体イメージングによる疼痛発症機構解明へのアプローチ
    岡田 卓也, TACHIBANA YOSHIHISA, NOMURA YUKI, OBATA NORIHIKO, MIZOBUCHI SATOSHI, WAKE HIROAKI
    第111回 近畿生理学談話会, Nov. 2018, Japanese, 和歌山, Domestic conference
    Oral presentation

  • In vivo tracing of single neuron activity with Ca2+ imaging of primary somatosensory cortex in mouse models of postoperative pain and inflammatory pain
    Takuya Okada, Yoshihisa Tachibana, Yuki Nomura, Norihiko Obata, Satoshi Mizobuchi, Hiroaki Wake
    Neuroscience 2018, Nov. 2018, English, San Diego, CA, International conference
    Poster presentation

  • 難治性心室頻拍に対する胸腔鏡下交感神経節切除術の麻酔経験
    松本 友里, 田口 真也, OBATA NORIHIKO, MIZOBUCHI SATOSHI
    日本麻酔科学会第64回関西支部学術集会, Sep. 2018, Japanese, 大阪, Domestic conference
    Poster presentation

  • 食道癌術後の気管胃管瘻閉鎖術における周術期気道管理
    原 翔平, EGI MORITOKI, NAKAGAWA AKEMI, OBATA NORIHIKO, IZUTA SHINICHIRO, MIZOBUCHI SATOSHI
    日本麻酔科学会第64回関西支部学術集会, Sep. 2018, Japanese, 大阪, Domestic conference
    Poster presentation

  • 冠動脈瘤を有するうつ病患者に対する修正型電気けいれん療法の麻酔経験
    中山 里穂, 吉田 卓矢, OBATA NORIHIKO, MIZOBUCHI SATOSHI
    日本麻酔科学会第64回関西支部学術集会, Sep. 2018, Japanese, 大阪, Domestic conference
    Oral presentation

  • In vivo tracing of single neuron activity with Ca2+ imaging of primary somatosensory cortex in mouse models of postoperative pain and inflammatory pain
    岡田 卓也, 橘 吉寿, NOMURA YUKI, OBATA NORIHIKO, MIZOBUCHI SATOSHI, WAKE HIROAKI
    Cold Spring Harbor Asia Confference, Sep. 2018, English, 淡路, International conference
    Poster presentation

  • 術後痛モデルマウスにおける第一次体性感覚野のin vivoカルシウムイメージング
    岡田 卓也, TACHIBANA YOSHIHISA, NOMURA YUKI, OBATA NORIHIKO, MIZOBUCHI SATOSHI, WAKE HIROAKI
    第41回日本神経科学大会, Jul. 2018, English, 神戸, Domestic conference
    Poster presentation

  • 術後痛モデルマウスにおける第一次体性感覚野 in vivo カルシウムイメージング
    岡田 卓也, 橘 吉寿, NOMURA YUKI, OBATA NORIHIKO, MIZOBUCHI SATOSHI, WAKE HIROAKI
    第5回イメージング数理研究会, Jul. 2018, Japanese, 神戸, Domestic conference
    Poster presentation

  • 術後痛モデルマウスにおける第一次体性感覚野 in vivo カルシウムイメージング
    岡田 卓也, 橘 吉寿, NOMURA YUKI, OBATA NORIHIKO, MIZOBUCHI SATOSHI, WAKE HIROAKI
    第41回日本神経科学大会, Jul. 2018, Japanese, 神戸, Domestic conference
    Poster presentation

  • 神戸大学における小児科と麻酔科の連携による脊髄性筋萎縮症のヌシネルセン治療
    永井 正志, 粟野 宏之, 松本 真明, 坊 亮輔, 冨岡 和美, 田中 司, 西山 将広, 前山 花織, 永瀬 裕朗, 小幡 典彦, 溝渕 知司, 西尾 久英, 飯島 一誠
    脳と発達, May 2018, Japanese, (一社)日本小児神経学会

  • 心臓手術中のハプトグロブリン投与による術後腎障害発生リスク低下は、術前腎機能低下患者でより強い
    小阪 円, EGI MORITOKI, KUBOTA KENTA, OBATA NORIHIKO, IZUTA SHINICHIRO, MIZOBUCHI SATOSHI
    日本麻酔科学会第65回学術集会, May 2018, Japanese, 日本麻酔科学会, 横浜, Domestic conference
    Oral presentation

  • 冠動脈瘤を有するうつ病患者に対する修正型電気けいれん療法の麻酔経験
    中山 里穂, 吉田卓矢, Obata Norihiko, Mizobuchi Satoshi
    日本麻酔科学会関西支部症例検討会, Feb. 2018, Japanese, 日本麻酔科学会, 大阪, Domestic conference
    Oral presentation

  • 非代償性急性心不全合併大動脈弁狭窄症に対する経皮的心肺補助併用下経カテーテル大動脈弁置換術の麻酔管理
    岡田 卓也, 吉田 卓矢, Makino Shohei, Obata Norihiko, Mizobuchi Satoshi
    The 22nd Annual Meeting of Japanese Society of Cardiovascular Anesthesiologists, Sep. 2017, Japanese, The Japanese Society of Cardiovascular Anesthesiologists, 宇都宮, 栃木, Domestic conference
    Poster presentation

  • The impact of intraoperative end tidal CO2 with the incidence of postoperative nausea and vomiting
    藤本 大地, Egi Moritoki, Nomura Yuki, Ooi Mayu, Obata Norihiko, Mizobuchi Satoshi
    日本麻酔科学会第64回学術集会, Jun. 2017, Japanese, 日本麻酔科学会, 神戸, Domestic conference
    Poster presentation

  • 当院における急性痛管理チームによる帝王切開術後鎮痛管理
    Obata Norihiko, 横尾 知樹, Mizobuchi Satoshi
    日本区域麻酔学会 第4回学術集会, Apr. 2017, Japanese, 日本区域麻酔学会, 名古屋, Domestic conference
    Poster presentation

  • 進行性核上性麻痺を合併した患者に対して区域麻酔で管理した一例
    東南 杏香, Obata Norihiko, Mizobuchi Satoshi
    日本区域麻酔学会 第4回学術集会, Apr. 2017, Japanese, 日本区域麻酔学会, 名古屋, Domestic conference
    Poster presentation

  • 食道アカラシアに対する経口内視鏡的筋層切開術(POEM)の麻酔経験―48症例の検討―
    西原 侑紀, 吉田 卓矢, Ooi Mayu, Obata Norihiko, Izuta Shinichiro, Mizobuchi Satoshi
    The 36th Annual Meeteing of the Japan Society for Clinical Anesthesia, Nov. 2016, Japanese, The Japan Society for Clinical Anesthesia, 高知, Domestic conference
    Poster presentation

  • 修正型電気けいれん療法におけるロクロニウムの使用経験
    横尾 知樹, Obata Norihiko, Mizobuchi Satoshi
    筋弛緩学術講演会in神戸, Nov. 2016, Japanese, MSD株式会社, 神戸, Domestic conference
    Oral presentation

  • ロボット支援腹腔鏡下前立腺全摘術における体温変化とシバリング発生に関する検討
    畑澤 佐知, Obata Norihiko, 藤本 大地, Nomura Yuki, Egi Moritoki, Mizobuchi Satoshi
    The 63rd Annual Meeting of the Japanese Society of Anesthesiologists, May 2016, Japanese, 日本麻酔科学会, 博多, Domestic conference
    Poster presentation

  • Intensive care management of paraneoplastic anti-NMDA receptor encephalitis: two cases report
    白川 尚隆, Misumi Takuyo, 藤本 大地, 西村 太一, 巻野 将平, 長江 正晴, Obata Norihiko, Egi Moritoki, Izuta Shinichiro, Mizobuchi Satoshi
    第43回日本集中治療医学会学術集会, Feb. 2016, Japanese, 日本集中治療医学会, 神戸, Domestic conference
    Oral presentation

  • 心臓手術患者におけるミルリノンの効果ー投与時期と対照薬に関するメタ解析－
    牛尾 将洋, Egi Moritoki, 若林 潤二, 西村 太一, 宮武 祐士, Obata Norihiko, Mizobuchi Satoshi
    日本臨床麻酔学会 第35回大会, Oct. 2015, Japanese, 日本臨床麻酔学会, 横浜, Domestic conference
    Poster presentation

  • Does Milrinone for Cardiac Surgery Patients Increase Mortality? Updated Meta-analysis and Sub-analysis for the Timing to Commence Milrinone and the Type of Control Agent.
    Masahiro Ushio, Egi Moritoki, Junji Wakabayashi, Taichi Nishimura, Yuji Miyatake, Obata Norihiko, Mizobuchi Satoshi
    American society of anesthesiology 2015, Oct. 2015, English, American society of anesthesiology, サンディエゴ, アメリカ, International conference
    Poster presentation

  • Heat moisture exchanger might reduce the fresh gas flow during Preoxygenation
    Taichi Nishimura, Egi Moritoki, Obata Norihiko, Izuta Shinichiro, Hiroshi Kita, Yuji MIYATAKE, Mizobuchi Satoshi
    12th Congress of the World Federation of Societies of Intensive and Critical Care Medicine (Seoul), Aug. 2015, English, World Federation of Societies of Intensive and Critical Care Medicine, ソウル, 韓国, International conference
    Poster presentation

  • 胸部食道癌術後の胃管気管支瘻に気管支瘻閉鎖術を施行後、ダブルルーメンチューブを用いた分離肺換気を行い管理した1例
    若林 潤二, Misumi Takuyo, 藤本 大地, Obata Norihiko, Egi Moritoki, Mizobuchi Satoshi
    第60回日本集中治療医学会近畿地方会, Jul. 2015, Japanese, 日本集中治療医学会近畿地方会, 大阪, Domestic conference
    Oral presentation

  • 術後集中治療を要する腹部手術患者における血中ナトリウム(Na)の濃度異常と周術期変動が術後予後に与える影響
    大田 有理, Okada Masako, Obata Norihiko, Egi Moritoki, Izuta Shinichiro, Mizobuchi Satoshi
    日本麻酔科学会 第62回学術集会 (5月30日)(神戸市), May 2015, Japanese, 日本麻酔科学会, 神戸, Domestic conference
    Poster presentation

  • The comparison between nafamostat mesilate and unfractionated heparin as anticoagulant during continuous renal replacement therapy
    Syohei Makino, Hiroshi Kita, Yuji Miyatake, Kenta Kubota, Takeshi Yokoyama, Obata Norihiko, Egi Moritoki, Takyo Misumi, Izuta Shinichiro, Mizobuchi Satoshi
    35th International Symposium On Intensive Care And Emergency Medicine, Mar. 2015, English, International Symposium on Intensive Care and Emergency Medicine, Brussels, International conference
    Poster presentation

  • 脊髄くも膜下硬膜外併用麻酔で管理したMarfan症候群合併妊婦の帝王切開術における麻酔管理
    佐々木 円, Izuta Shinichiro, Obata Norihiko, Mizobuchi Satoshi
    日本臨床麻酔学会第34会大会, Nov. 2014, Japanese, 日本臨床麻酔学会, 品川, Domestic conference
    Poster presentation

  • 胸腹部大動脈手術時の運動誘発電位低下に対し集学的治療を行った一症例
    柘植 江里香, 内藤 嘉之, 久保田 健太, Obata Norihiko, Egi Moritoki, Mizobuchi Satoshi
    日本心臓血管麻酔学会第19回学術集会, Sep. 2014, Japanese, 日本心臓血管麻酔学会, 大阪, Domestic conference
    [Invited]
    Invited oral presentation

  • Pain Disability and Exacerbation Factor in Patients With Chronic Pain
    Shinichi Ishikawa, Daniel Obata, Hiroyuki Nishie, Makako Kinoshita, Obata Norihiko
    Annual Meeting of American Society of Anesthesiologists 2013, Oct. 2013, English, San Francisco, USA, International conference
    Poster presentation

  • 麻薬中止後に離脱症状に関連して急性心筋梗塞を発症した1症例
    賀来 隆治, Obata Norihiko, 小畑 ダニエル, 福永 賀予, 藤井 真樹子, 西江 宏行, 石川 慎一, 佐藤 健治, Mizobuchi Satoshi, 森田 潔
    日本ペインクリニック学会 第47回大会, Jul. 2013, Japanese, 日本ペインクリニック学会, さいたま市, Domestic conference
    Oral presentation

  • 先天性側彎症の術後腰痛に対し後枝内側枝の高周波熱凝固治療が著効した1症例
    小畑 ダニエル, 石川 慎一, 木下 真佐子, Obata Norihiko, 賀来 隆治, 西江 宏行, 佐藤 健治, Mizobuchi Satoshi, 森田 潔
    日本ペインクリニック学会 第47回大会, Jul. 2013, Japanese, 日本ペインクリニック学会, さいたま市, Domestic conference
    Oral presentation

  • パルス高周波熱凝固法が著効した肝細胞癌腰椎骨転移の一症例
    小畑 ダニエル, 西江 宏行, 石川 慎一, 安積 さやか, 福永 賀予, Obata Norihiko, 藤井 真樹子, 賀来 隆治, 佐藤 健治, Mizobuchi Satoshi, 森田 潔
    日本ペインクリニック学会 第47回大会, Jul. 2013, Japanese, 日本ペインクリニック学会, さいたま市, Domestic conference
    Oral presentation

  • 先天性側彎症の術後腰痛に対し後枝内側枝の高周波熱凝固治療が著効した1症例
    小畑 ダニエル, 石川 慎一, 木下 真佐子, 小幡 典彦, 賀来 隆治, 西江 宏行, 佐藤 健治, 溝渕 知司, 森田 潔
    日本ペインクリニック学会誌, Jun. 2013, Japanese, (一社)日本ペインクリニック学会

  • Comparison of Intraoperative Oxygen Consumption between Living Donor Liver Transplantation and Orthotopic Liver Transplantation
    松崎 孝, 賀来 隆治, Obata Norihiko, 柴田 麻理, 森松 博史, 森田 潔
    The 60th Annual Meeting of the Japanese Society of Anesthesiologists, May 2013, Japanese, The Japanese Society of Anesthesiologists, 札幌, 昨年我々は第59回日本麻酔科学会総会にて、生体肝移植術中における酸素消費量の推移に関して報告を行った。術中酸素消費量は再灌流を契機に上昇する傾向が認められたがその臨床的意義に関しては不明であった。今回当院で施行された脳死及び生体肝移植術中における酸素消費量の比較を行ったので報告する。対象：2011年10月1日から2012年10月30日までに脳死及び生体肝移植術を受けた18歳以上のレシピエント22名（再移植症例1例を含む）。方法と測定項目：前向きの観察研究で脳死群10例と生体群13例の2群に分類して、患者背景（年齢、性別、BMI、MELDスコアー）及び術中酸素消費量に関して比較検討を行った。術中酸素消費量はDatex-Ohmeda社の間接熱量計を使用して測定。全身麻酔導入後、前無肝期、無肝期、再還流1時間後、閉腹時の5点で測定を施行した。結果：患者背景, Domestic conference
    Poster presentation

  • The consideration about the appropriate timing of extubation after pediatric living related liver transplantation
    賀来 隆治, 松崎 孝, Obata Norihiko, 柴田 麻理, 森松 博史, 森田 潔
    The 60th Annual Meeting of the Japanese Society of Anesthesiologists, May 2013, Japanese, The Japanese Society of Anesthesiologists, 札幌, 【はじめに】小児肝移植術後Fast-Track管理は、欧米において術後合併症の軽減とICU滞在期間を短縮するなどの利点が報告されている。その臨床的意義について検証するため、今回当院で施行された小児生体肝移植術後の抜管時期、及び再挿管が必要となった症例に関して後ろ向きに比較・検討した。【対象】2005年1月1日から2012年11月30日までに施行された10歳以下の小児生体肝移植レシピエント28名とし、術後48時間以内に抜管が施行された症例14例（A群：そのうち2例は手術室で抜管）と48時間以降に抜管が施行された12例（B群）を比較対象とした。患者背景は1歳以下が16症例、男女比は11：17、患者の平均体重は8.5kg（4.6-22kg）であった。移植が必要となった原疾患の内訳は胆道閉鎖症が16例、先天性代謝異常疾患が8例、その他が4症例であった。【検討, Domestic conference
    Poster presentation

  • The change of HADS score and PCS score by multidisciplinary chronic pain treatment at the Pain Liaison clinic
    木下 真佐子, 石川 慎一, 西江 宏行, Obata Norihiko, Mizobuchi Satoshi, 森田 潔
    The 60th Annual Meeting of the Japanese Society of Anesthesiologists, May 2013, Japanese, The Japanese Society of Anesthesiologists, 札幌, 難治性慢性痛は心理社会的な要因を含み、集学的治療による多角的な治療が推奨されている。当科では他科と連携して痛みのリエゾン外来を開設しており、問診票による評価の後に麻酔科医、整形外科医、精神看護専門看護師、理学療法士による診察を行い、患者自身で出来る運動方法を指導している。今回我々は、この外来での集学的治療とその心理的効果を検討した。対象と方法：当科外来通院中の慢性痛患者で、心理社会的要因を含む可能性が高い症例あるいは、通常の治療で奏功しないリエゾン紹介患者19症例を対象とした。方法は初診時と3カ月後のHADS(hospital anxiety depression scale)とPCS(pain catastrophizing scale)を検討した。HADSは不安とうつを、PCSは痛みの破局的思考を反芻、無力感、拡大視で評価するものである。初診時と, Domestic conference
    Poster presentation

  • パルス高周波熱凝固法が著効した肝細胞癌腰椎骨転移の一症例
    小畑 ダニエル, 西江 宏行, 石川 慎一, 安積 さやか, 福永 賀予, 小幡 典彦, 藤井 真樹子, 賀来 隆治, 佐藤 健治, 溝渕 知司, 森田 潔
    日本ペインクリニック学会誌, Feb. 2013, Japanese, (一社)日本ペインクリニック学会

  • 麻薬中止後に離脱症状に関連して急性心筋梗塞を発症した1症例
    賀来 隆治, 小幡 典彦, 小畑 ダニエル, 福永 賀予, 藤井 真樹子, 西江 宏行, 石川 慎一, 佐藤 健治, 溝渕 知司, 森田 潔
    日本ペインクリニック学会誌, Feb. 2013, Japanese, (一社)日本ペインクリニック学会

  • 当院におけるトラムセット配合錠の使用状況
    小幡 典彦, 賀来 隆治, 西江 宏行, 石川 慎一, 溝渕 知司
    日本ペインクリニック学会誌, Jun. 2012, Japanese, (一社)日本ペインクリニック学会

  • オーストラリアにおける慢性痛の診療
    石川 慎一, 小畑 ダニエル, 木下 真佐子, 藤井 真樹子, 小幡 典彦, 賀来 隆治, 西江 宏行, 佐藤 健治, 溝渕 知司, 森田 潔
    日本ペインクリニック学会誌, Jun. 2012, Japanese, (一社)日本ペインクリニック学会

  • MRIに脳脊髄液漏出の評価を行った硬膜穿刺後頭痛の2症例
    藤井 真樹子, 石井 慎一, 西江 宏行, 小畑 ダニエル, 小幡 典彦, 賀来 隆治, 佐藤 健治, 溝渕 知司, 森田 潔
    日本ペインクリニック学会誌, Jun. 2012, Japanese, (一社)日本ペインクリニック学会

  • 神経障害性疼痛のメカニズムと最新の治療 神経障害性痛を持つがん患者に対するインターベンション
    西江 宏行, 溝渕 知司, 石川 慎一, 賀来 隆治, 小幡 典彦, 佐藤 健治, 藤井 真樹子, 小畑 ダニエル, 木下 真佐子, 友塚 直人, 守屋 佳恵, 森田 潔
    日本緩和医療学会学術大会プログラム・抄録集, Jun. 2012, Japanese, (NPO)日本緩和医療学会

  • トラマドールの導入が有効だったがん性痛の2例
    松井 治暁, 西江 宏行, 松三 絢弥, 谷口 新, 藤井 真樹子, 賀来 隆治, 小幡 典彦, 石川 慎一, 佐藤 健治, 溝渕 知司, 森田 潔
    日本ペインクリニック学会誌, Sep. 2011, Japanese, (一社)日本ペインクリニック学会

  • MRIミエログラフィーが治療前後の診断に有用であった脳脊髄液減少症の2症例
    友塚 直人, 石川 慎一, 小幡 典彦, 溝渕 知司, 橋本 秀則, 森田 潔
    日本ペインクリニック学会誌, Jun. 2009, Japanese, (一社)日本ペインクリニック学会

■ Research Themes
  • 糖尿病モデルマウスにおける術後認知機能障害への脳内モノアミンの関与
    小幡 典彦
    日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 01 Apr. 2022 - 31 Mar. 2025
    本研究では、糖尿病モデルマウスを用いて、術前にノルアドレナリン、ドパミンなどの神経伝達物質、あるいはその拮抗薬を投与することで、術後認知機能に与える影響を行動評価と分子レベルの解析を施行して調査し、さらに、手術侵襲前の血糖コントロール介入が術後認知機能障害発生に与える影響を明らかにすることを目指す。モノアミン動態の経時的な変化を調べることで、糖尿病が術後認知機能障害の危険因子とされる病態機序の解明や、術後認知機能障害の予防策に繋げることが期待できる。 現在、C57BL/6J雄性マウスを用いて、6週齢より高脂肪食を8週間摂食させた2型糖尿病モデルマウスを作製し、腸管操作を伴う開腹手術侵襲を与えると同時に、手術侵襲前後での認知機能を評価するための行動評価を行っている。ストレプトゾシン腹腔内投与にて作製する1型糖尿病モデルについても同様の評価を行う。今後は、術前にモノアミン関連薬剤（ノルアドレナリン、ドパミン、それらの阻害薬）の脳室内投与を行い、手術侵襲前後での認知機能を評価するための行動実験、血液、脳組織サンプルを解析する。さらには、血糖値の変化と周術期の認知機能変化の関連性を探るために、糖尿病モデルマウスに対して術前に血糖コントロール介入を行い、術前にモノアミン関連薬剤および阻害剤を投与する群、投与しない群のそれぞれに手術侵襲を与え、手術侵襲前後での行動実験を行う。その後、血液、脳組織サンプルを採取し、解析する予定である。

  • Obata Norihiko
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Kobe University, Apr. 2017 - Mar. 2020, Principal investigator
    In this study, we investigated perioperative behavioral changes and various mRNA expression levels including neurotrophic factors in the brain using type 2 diabetes model mice. Type 2 diabetes model mice were prepared by feeding a high fat diet. The behavior was evaluated by a series of protocols including an open field test, a novel object recognition test, and a light-dark box test. An open abdominal surgery was performed as a surgical invasion. After the behavioral experiment, brain tissues (frontal cortex) were collected and analyzed for mRNA expression levels of neurotrophic factors and catecholamine receptors using real-time PCR. Postoperative activity decreased in type 2 diabetic model mice, suggesting that altered expression level of neurotrophic factors or catecholamines in the brain might be affecting.
    Competitive research funding

  • Gene Therapy for Chronic pain by modulating the SNPs of pacemaker ion channels.
    Ryuji Kaku, OBATA Norihiko
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Okayama University, 01 Apr. 2013 - 31 Mar. 2016
    The pace maker ion channels play a major role on regulating the neuropathic pain, especially it work as modulator at the shift state from acute pain to chronic pain. It is also reported that the SNPs of that ion channels do not pass the current, but it exist on the cell surface. We investigated that cyclic AMP can reduce the expression that ion channels to the cell membrane, and it also can decrease the pain behavior of rat spinal nerve ligation (SNL) model. It suggests that over expression of SNPs ion channels can reduce the pain current, and may inhibit the shift from acute pain to chronic pain.

  • OBATA Norihiko
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Young Scientists (B), Kobe University, 01 Apr. 2013 - 31 Mar. 2015, Principal investigator
    The objective of this study is to inhibit the expression of brain-derived neurotrophic factor (BDNF), which plays a pivotal role in the development of neuropathic pain, using an adeno-associated virus vector (AAV). First, we designed an AAV vector containing small interfering (si)RNA that inhibits the expression of specific BDNF related to pain. Then we plan to administer the AAV vector in the spinal subarachnoid space in animal pain models, confirm the BDNF synthesis inhibition in ganglia and examine its analgesic effect. Eventually, we intend to assess the safety of this therapy, and make this strategy developed in clinical.
    Competitive research funding

  • Basic research of pain control by DNA decoy for brain-derived neurotrophic factor
    YOKOYAMA Masataka, OBATA Norihiko, MATSUOKA Yoshikazu
    Japan Society for the Promotion of Science, Grants-in-Aid for Scientific Research, Grant-in-Aid for Scientific Research (C), Kochi University, 2009 - 2011
    We made DNA decoy for brain-derived neurotrophic factor(BDNF) exon-1 that is increased significantly in the spinal level of neuropathic pain model. We administered DNA decoy intrathecally to knock-down BDNF exon-1 in pain model rats, and confirmed that pain response was decreased by DNA decoy.

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