A new method of monitoring paraplegia due to spinal cord ischemia and a new management method for delayed onset paralysis.

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K18269
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Hamamatsu University School of Medicine
• Principal Investigator: kawashima shingo 浜松医科大学, 医学部, 助教 (10467251)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 脊髄モニター

Outline of Final Research Achievements

It is essential to understand the characteristics of spinal cord blood flow, which is complicated by collateral pathways, and to make efforts to maintain spinal cord blood flow during surgery. In this study, we investigated changes in blood flow using near-infrared spectroscopy as an intraoperative monitor and to find an effective anesthetic method for MEP, which is indispensable for intraoperative monitoring. We also evaluated whether the effects of ischemia could be monitored continuously after the surgery as a postoperative monitor. It is important to plan a staged repair as much as possible for any procedure, and after endovascular thoracoabdominal aortic repair without branch artery reconstruction, attention must be paid to the prevention of secondary attacks. Cerebrospinal fluid drainage with attention to systemic circulatory and respiratory control, improvement of anemia, and drainage rate is an effective preventive treatment for spinal cord injury.

Free Research Field

心臓血管麻酔

Academic Significance and Societal Importance of the Research Achievements

近年、胸部・胸腹部ステントグラフトの普及や脊髄血液供給に関する理解が深まり、脊髄損傷の予防対策がかなり変化してきている。どのような治療法においても、確実な治療法はないのが現状であり、その要因は発生率の低さであるが、やはり、正確にモニターできるものがないということも重要な因子である。今回、手術中のモニターであるMEPを中心に、麻酔がそれに与える影響をとらえ、特に出血についてどのように影響するかを示すことができた。また、二次発作の予防に注意を払う必要があり、NIRSがその重要なモニターになる可能性が示唆される。その中でも循環の維持のために循環血液量の確保は重要な要素であった。