| Project/Area Number |
15K20934
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
Emergency medicine
General surgery
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| Research Institution | The University of Tokyo |
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Principal Investigator |
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| Project Period (FY) |
2015-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2017: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2016: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2015: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
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| Keywords | デクスメデトミジン / 手術麻酔管理 / 高齢者医療 / 心臓外科手術 / 心臓血管外科手術 / 周術期医療 / 交感神経抑制 / 周術期生体管理 / 外科 / 循環器・高血圧 / 麻酔科学 |
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| Outline of Final Research Achievements |
The effect of combined use of dexmedetomidine on general anesthesia on hemodynamics was investigated in elderly patients and cardiac surgery. Comparing the increase in systolic blood pressure during sternotomy, which was a major invasion, a tendency of suppression was observed, but there was a large difference between cases.
It was suggested that dexmedetomidine may suppress vital fluctuations during invasion, but it was not shown with a significant difference. The decrease in the number of β-blocker use cases also supports the small fluctuation of vital signs. Although there was a large difference in the effect depending on the case, it is possible that preoperative cardiac reserve was affected. It is possible that a group of subjects for which dexmedetomidine use is more appropriate can be found by extracting the confounding factors that are the background by further statistical studies.
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| Academic Significance and Societal Importance of the Research Achievements |
手術医療においては、全身麻酔下に生体に多大な侵襲が与えられる。心臓血管外科症例に代表される侵襲の大きな手術が積極的に取り組まれる一方で、高齢者がそのような手術を受ける機会も近年益々増加しており、侵襲制御技術の向上が求められている。手術侵襲に伴う交感神経の亢進や血圧変動は、可能な限り抑制することが麻酔管理上求められるが、近年適応範囲が見直されているデクスメデトミジンは、その鎮静作用と交感神経抑制作用により、循環動態を安定させる可能性がある。
本研究により、デクスメデトミジンが侵襲時のバイタル変動抑制に寄与する可能性を示唆されたが、同時に、効果の高い群と低い群が存在する可能性が示唆された。
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