| Co-Investigator(Kenkyū-buntansha) |
ISONO Shiroh Chiba University, Chiba University Hospital, Assistant Professor, 医学部附属病院, 講師 (80212968)
TANAKA Atsuko Chiba University, Graduate School of Medicine, Research Associate, 大学院・医学研究院, 助手 (40302559)
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| Budget Amount *help |
¥3,100,000 (Direct Cost: ¥3,100,000)
Fiscal Year 2005: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 2004: ¥2,600,000 (Direct Cost: ¥2,600,000)
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| Research Abstract |
1.Anatomical factors of upper airway function in perioperative management
(1)Effects of head and neck position and mouth opening on upper airway patency
Influences of head and neck position and mouth opening on the patency of passive pharynx were examined in sleep-disordered patients. Pharyngeal patency was assessed endoscopically. As compared with neutral head and neck position (mouth closed), pharyngeal patency was improved by neck extension whereas it was deteriorated by neck flexion and mouth opening.
(2)Effects of sniffing position on pharyngeal patency in patients with obstructive sleep apnea
Sniffing position is widely known as an appropriate head and neck position for direct laryngoscopy, however, its possible effects on pharyngeal patency had never been examined. In patients with obstructive sleep apnea, the collapsibility of the passive pharynx was evaluated endoscopically. Sniffing position structurally improves maintenance of the passive pharyngeal airway in patients with obstr
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uctive sleep apnea and may be beneficial for both mask ventilation and tracheal intubation during anesthesia induction.
2.Neurological factors of upper airway function in perioperative management
To investigate how sevoflurane modifies airway protective reflexes in anesthetized children (0-12 ys), a small dose, 0.02 mL/kg of distilled water (minimum 0.2 mL) was instilled to the larynx to evoke an airway protective reflex. Depending on the depth of anesthesia, the subjects were divided into two groups : Group 1 and Group 2 (1% and 2% of end-tidal sevoflurane concentration, respectively). The responses were categorized into passive (laryngeal closure, laryngospasm, and apnea) and active (cough, expiration reflex, and swallowing reflex) responses. In both groups, the primary responses were passive ; however, in Group 1, active reflexes were also observed in 8 of 10 subjects ; no subjects in Group 2 had active reflexes. We concluded that, in children, the depth of general anesthesia with sevoflurane modified airway protective reflexes. Less
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