1.Influence of general anesthesia on the postoperative sleep cycle in patients undergoing surgery and dental treatment: a scoping review on the incidence of postoperative sleep disturbance
Terumi AYUSE ; Shinji KURATA ; Gaku MISHIMA ; Mizuki TACHI ; Erika SUZUE ; Kensuke KIRIISHI ; Yu OZAKI-HONDA ; Takao AYUSE
Journal of Dental Anesthesia and Pain Medicine 2023;23(2):59-67
General anesthesia may influence the postoperative sleep cycle; however, no clinical studies have fully evaluated whether anesthesia causes sleep disturbances during the postoperative period. In this scoping review, we explored the changes in postoperative sleep cycles during surgical procedures or dental treatment under general anesthesia.We compared and evaluated the influence of general anesthesia on sleep cycles and sleep disturbances during the postoperative period in adult and pediatric patients undergoing surgery and/or dental treatment. Literature was retrieved by searching eight public databases. Randomized clinical trials, observational studies, observational case-control studies, and cohort studies were included. Primary outcomes included the incidence of sleep, circadian cycle alterations, and/or sleep disturbances. The search strategy yielded six studies after duplicates were removed. Finally, six clinical trials with 1,044 patients were included. In conclusion, general anesthesia may cause sleep disturbances based on alterations in sleep or the circadian cycle in the postoperative period in patients scheduled for elective surgery.
2.Comparison of the hemodynamic effects of propofol and ketamine as anesthetic induction agents during high-dose remifentanil administration: a single-center retrospective comparative study.
Takuro SANUKI ; Gaku MISHIMA ; Shinji KURATA ; Toshihiro WATANABE ; Kensuke KIRIISHI ; Mizuki TACHI ; Yu OZAKI ; Ichiro OKAYASU ; Mari KAWAI ; Yuki MATSUSHITA ; Keiichiro MIURA ; Takao AYUSE
Journal of Dental Anesthesia and Pain Medicine 2015;15(3):129-134
BACKGROUND: We hypothesized that ketamine, when administered as the anesthetic induction agent, may prevent cardiovascular depression during high-dose remifentanil administration, unlike propofol. To test our hypothesis, we retrospectively compared the hemodynamic effects of ketamine, during high-dose remifentanil administration, with those of propofol. METHODS: Thirty-eight patients who underwent oral surgery at the Nagasaki University Hospital between April 2014 and June 2015 were included in this study. Anesthesia was induced by the following procedure: First, high-dose remifentanil (0.3-0.5 µg/kg/min) was administered 2-3 min before anesthesia induction; next, the anesthetic induction agent, either propofol (Group P) or ketamine (Group K), was administered. Mean arterial pressure (MAP) and the heart rate were recorded by the automated anesthesia recording system at four time points: immediately before the administration of high-dose remifentanil (T1); immediately before the administration of propofol or ketamine (T2); 2.5 min (T3), and 5 min (T4) after the administration of the anesthetic induction agent. RESULTS: In Group P, the MAP at T3 (75.7 ± 15.5 mmHg, P = 0.0015) and T4 (68.3 ± 12.5 mmHg, P < 0.001) were significantly lower than those at T1 (94.0 ± 12.4 mmHg). However, the MAP values in the K group were very similar (P = 0.133) at all time points. The heart rates in both Groups P (P = 0.254) and K (P = 0.859) remained unchanged over time. CONCLUSIONS: We showed that ketamine, when administered as the anesthetic induction agent during high-dose remifentanil administration, prevents cardiovascular depression.
Anesthesia
;
Arterial Pressure
;
Depression
;
Heart Rate
;
Hemodynamics*
;
Humans
;
Ketamine*
;
Propofol*
;
Retrospective Studies*
;
Surgery, Oral
3.Comparison of the hemodynamic effects of propofol and ketamine as anesthetic induction agents during high-dose remifentanil administration: a single-center retrospective comparative study.
Takuro SANUKI ; Gaku MISHIMA ; Shinji KURATA ; Toshihiro WATANABE ; Kensuke KIRIISHI ; Mizuki TACHI ; Yu OZAKI ; Ichiro OKAYASU ; Mari KAWAI ; Yuki MATSUSHITA ; Keiichiro MIURA ; Takao AYUSE
Journal of Dental Anesthesia and Pain Medicine 2015;15(3):129-134
BACKGROUND: We hypothesized that ketamine, when administered as the anesthetic induction agent, may prevent cardiovascular depression during high-dose remifentanil administration, unlike propofol. To test our hypothesis, we retrospectively compared the hemodynamic effects of ketamine, during high-dose remifentanil administration, with those of propofol. METHODS: Thirty-eight patients who underwent oral surgery at the Nagasaki University Hospital between April 2014 and June 2015 were included in this study. Anesthesia was induced by the following procedure: First, high-dose remifentanil (0.3-0.5 µg/kg/min) was administered 2-3 min before anesthesia induction; next, the anesthetic induction agent, either propofol (Group P) or ketamine (Group K), was administered. Mean arterial pressure (MAP) and the heart rate were recorded by the automated anesthesia recording system at four time points: immediately before the administration of high-dose remifentanil (T1); immediately before the administration of propofol or ketamine (T2); 2.5 min (T3), and 5 min (T4) after the administration of the anesthetic induction agent. RESULTS: In Group P, the MAP at T3 (75.7 ± 15.5 mmHg, P = 0.0015) and T4 (68.3 ± 12.5 mmHg, P < 0.001) were significantly lower than those at T1 (94.0 ± 12.4 mmHg). However, the MAP values in the K group were very similar (P = 0.133) at all time points. The heart rates in both Groups P (P = 0.254) and K (P = 0.859) remained unchanged over time. CONCLUSIONS: We showed that ketamine, when administered as the anesthetic induction agent during high-dose remifentanil administration, prevents cardiovascular depression.
Anesthesia
;
Arterial Pressure
;
Depression
;
Heart Rate
;
Hemodynamics*
;
Humans
;
Ketamine*
;
Propofol*
;
Retrospective Studies*
;
Surgery, Oral
4.A Case of Open Surgery for Endoleak after Thoracic Endovascular Aortic Repair of the Aortic Arch
Yuki MOCHIDA ; Junichi SHIMAMURA ; Shigeru SAKURAI ; Kensuke OZAKI ; Susumu OSHIMA ; Takuya FUJIKAWA ; Yuji SEKINE ; Shin YAMAMOTO ; Shirou SASAGURI
Japanese Journal of Cardiovascular Surgery 2018;47(1):26-30
A 72-year-old woman underwent thoracic endovascular aortic repair (TEVAR) for an aortic arch aneurysm at a previous hospital. During follow-up, although the aneurysm was found to have become bigger, no further treatments were given, except for conservative follow-up. The patient sought a second opinion and thus visited our hospital. Enhanced computed tomography (CT) revealed a type I endoleak that required repair. Total arch replacement with removal of the partial stent-graft system was performed under deep hypothermic circulatory arrest. The patient made a steady progress postoperatively and was discharged without any complications. Endovascular repair is minimally invasive and frequently used in various medical facilities but carries a considerably high risk of reintervention. Treatment strategies for aortic aneurysm, including open surgery, should be carefully chosen.