Publications by authors named "Kazuo Hanaoka"

Patients with chronic pain are affected psychologically and socially. There are also individual differences in treatment efficacy. Insufficient research has been conducted on genetic polymorphisms that are related to individual differences in the susceptibility to chronic pain.

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Chronic pain is reportedly associated with the transient receptor potential canonical 3 () gene. The present study examined the genetic associations between the single-nucleotide polymorphisms (SNPs) of the gene and chronic pain. The genomic samples from 194 patients underwent linkage disequilibrium (LD) analyses of 29 SNPs within and around the vicinity of the gene.

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Acute pain that is associated with herpes zoster (HZ) can become long-lasting neuropathic pain, known as chronic post-herpetic neuralgia (PHN), especially in the elderly. HZ is caused by the reactivation of latent varicella-zoster virus (VZV), whereas PHN is not attributed to ongoing viral replication. Although VZV infection reportedly induces neuronal cell fusion in humans, the pathogenesis of PHN is not fully understood.

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Article Synopsis
  • Chronic pain has a heritability factor ranging from 30% to 70%, suggesting a genetic component to its susceptibility and treatment outcomes.
  • A genome-wide association study (GWAS) with over 700,000 markers across 191 chronic pain patients identified the rs4773840 SNP as significantly associated with postherpetic neuralgia (PHN) and pointed to another gene as linked to chronic pain in trend models.
  • No significant associations were found between genetic variants and the effectiveness of pain medications, indicating that while genetics may influence pain susceptibility, they may not predict drug efficacy.
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Background: Pre-anaesthesia hypertension (PAH) occurs when the blood pressure (BP) in patients before surgery, in the operating room, before anaesthesia induction, temporally elevates regardless of normal ambulatory recorded BP or self-measured BP at home. PAH might be caused by anxiety and mental stress about the anaesthesia and surgery. We know that most of the patients with sustained hypertension (SH) are elders, males, obese subjects, and dyslipidaemic subjects.

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Objectives: Minimally invasive epiduroscopy has recently been reported as an effective treatment procedure for chronic and intractable low back pain. However, no study has determined safe anesthetics for monitored anesthesia care during epiduroscopy. We aimed to compare and evaluate conventional monitored anesthesia care drugs with dexmedetomidine.

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Article Synopsis
  • Varying temperatures impact heart function by altering cardiac contraction (systolic) and relaxation (diastolic) dynamics, which are reflected in the left ventricular pressure-time curve (PTC) waveform.
  • The study introduces half-logistic (h-L) time constants as superior indicators for measuring heart muscle strength (inotropism) and relaxation (lusitropism) compared to traditional mono-exponential (m-E) time constants, even under varying temperatures.
  • Analysis of excised canine hearts at different temperatures demonstrated that h-L functions provided a better fit for the PTC segments, confirming their effectiveness as temperature-dependent indices for assessing heart function.
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Methods of pain treatment are various because of different mechanisms and causes of pain. However, we should recognize complications and side effects of these methods of pain treatment. In addition, we should understand the prevention and management of these complications and side effects.

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Background: Myocardial contraction and relaxation are regulated by increases and decreases in cytoplasmic calcium concentration ([Ca(2+)]i). In previous studies, we found that a half-logistic (h-L) function, which represents a half-curve of a symmetrical sigmoid logistic function with a boundary at the inflection point, curve-fits the first half of the ascending phase and the second half of the descending phase of the [Ca(2+)]i transient curve better than a mono-exponential (m-E) function. In the present study, we investigated the potential application of an h-L function to analyse the first half of the descending phase of CaTC (CaTCIII).

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Taking EMLA cream and Penles tape 18 mg as examples, this article describes the conditions for skin penetration of topical anesthetics, with their onset time of action, duration of effect and a precautions for their use. EMLA cream is a unique cream for topical anesthesia which is the eutectic mixture of lidocaine and propitocaine to increase skin penetration. The safety study demonstrated that blood concentrations of active ingredients of EMLA cream were below toxic levels.

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Chronic intractable pain is difficult to manage as the mechanisms of chronic pain are complicated. Recently rehabilitation is used in patients with chronic pain not responding to NSAIDs, non-opioids, anti-depressants and so on. Rehabilitation includes acute, recovery and maintained modes of rehabilitation.

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This article describes the first events of general anesthesia in the world by Tokumei Takamine in 1698 and Seishu Hanaoka in 1804, the establishment of anesthesiology in Japan including the meaning of a scientific society, the establishment of Japanese Society of Anesthesiologist and Department of Anesthesiology at University of Tokyo, past contributions to anesthesiology by Japanese anesthesiologists, and contributions to anesthesiology by Journal of Anesthesia and the Japanese Journal of Anesthesiology.

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The article describes an analysing device that measures the perception and intensity of pain quantitatively. While it is not necessarily true that psychological aspect is totally irrelevant to pain measurement, this device is remarkable in that it is capable of measuring the intensity of pain felt by the patient more objectively by using electric stimuli. The feature of this device is that it uses a non-pain heteresthesia for measuring the intensity of pain.

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New diagnostic and therapeutic devices for patients with chronic intractable pain are used in Japan. The following articles describe topics of new diagnostic and therapeutic devices for patients with chronic intractable pain including thermography, functional MRI, device for the quantitative analysis of perception and pain sensation, epiduroscopy, device for phototherapy, Racz catheter and device for spinal cord stimulation (SCS).

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Recently, new drugs for intractable chronic pain are available in Japan. The following articles describe topics of new drugs for intractable chronic pain including transdermal fentanyl, tramadol/acetaminophen combination tablets, buprenorphine transdermal patch, pregabalin, and duloxetine. Treatment of constipation in chronic pain patients and management of opioid induced nausea and vomiting are also described to prevent complication of pain-relief drug therapy.

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Background: Myocardial contraction and relaxation are regulated by increases and decreases in intracellular cytoplasmic calcium (Ca(2+)) concentration ([Ca(2+)]i). In previous studies, we found that a half-logistic (h-L) function, which represents a half-curve of a symmetrical sigmoid logistic function with a boundary at the inflection point, curve-fits the first half of the ascending phase (CaTI) and the second half of the descending phase of the [Ca(2+)]i transient curve (CaTIV) better than a mono-exponential (m-E) function. In the present study, we investigated the potential application of an h-L function to the analysis of the second half of the ascending phase of the [Ca(2+)]i transient curve (CaTII).

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We should take care of the occurrences of apnea and hypopnea after emergence from general anesthesia in the children with sleep apnea syndrome (SAS) due to an increase in sensitivity to opioid agonists given for previous recurrent hypoxia. Preoperative assessment for SAS with apnea hypopnea index (AHI), oxygen desaturation index (ODI), and minimum artery oxygen saturation by pulse oxymetry (lowest SpO2) obtained from polysomnography (PSG) test could help to predict the postoperative respiratory depression. In perioperative management in the children with SAS who are candidates for adenotonsillectomy, the dose of opioid agonists during anesthesia maintenance for purpose of postoperative analgesia and sedation should be reduced; postoperative respiratory and circulatory management with monitoring of respiratory movement of the thoracoabdominal part, and electrographic (ECG) and SpO2 monitoring should be continued intensively under long-term oxygen administration; and airway management, nasal continuous positive airway pressure (nCPAP), and artificial ventilation should be prepared for the occurrence of postoperative respiratory depression.

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The following articles describe topics of phototherapy including low reactive laser therapy by diode laser device, semiconductor as a medium consisting of aluminum, gallium and arsenic, near infrared light irradiator using halogen lamp, and xenon light by high-intensity electrical stimulation of xenon gas. In addition, the applications of phototherapy in the clinical medicine such as rehabilitation, orthopedics and pain clinic are described. Phototherapy is a useful and safe method for pain relief.

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Article Synopsis
  • The release of calcium from the sarcoplasmic reticulum in cardiac muscles is linked to anesthetic-induced heart problems, and earlier research indicated that a half-logistic function fits myocardial tension data better than a mono-exponential function.
  • Researchers measured calcium transients in isolated rabbit and mouse heart muscles using a specific photoprotein and analyzed the data using both half-logistic and mono-exponential functions.
  • The results showed that half-logistic curves were more accurate in reflecting the calcium transients than mono-exponential functions, suggesting that the half-logistic time constant could be a better indicator for assessing calcium release in heart muscle cells.
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This chapter describes physical pain including pain, anorexia-cachexia syndrome, nausea-vomiting, abdominal distention, ascites, constipation and dyspnea. In effect, patients are more likely to present with several concurrent symptoms. Each of these symptoms is described separately in this chapter.

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Cancer pain is very unpleasant often difficult to treat. Therefore, we should recognize the mechanisms of cancer pain and know the physical pain, psychological pain, social pain and spiritual pain as total pain. Besides, we must understand how to evaluate the cancer pain using the methods of assessment of cancer pain, and scales of pain degree (VAS, NRS, VRS, FRS, FVAS).

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Intravenous patient-controlled analgesia (IV-PCA) using opioids such as morphine and fentanyl can be an effective analgesic method for post-operative pain that is resistant to conventional administration of narcotic analgesics and nonsteroidal anti-inflammatory drugs, and where epidural block and peripheral nerve block are not feasible. In addition to post-operative pain relief, IV-PCA can facilitate early ambulation, reduce respiratory complications, and increase patient satis-faction. However, respiratory and circulatory depression, and post-operative nausea and vomiting (PONV) often occur as side effects of IV-PCA with opioids.

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Pentazocine is a widely used mixed agonist-antagonist opioid. Previous animal studies have demonstrated that pentazocine-induced antinociception displayed a ceiling effect characterized by biphasic dose response with a increasing and then descending analgesia like a bell-shaped curve. This study attempted to clarify the mechanisms underlying such dose-response relationships.

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Agitation during the emergence from general anesthesia is a great post-operative problem that often injures the patients themselves and requires the medical staff to restrain and calm the patients. The predisposing factors for emergence agitation include anesthesia, operation, and patient. Sevoflurane anesthesia results in higher incidence of emergence agitation than halothane, because of the rapid emergence, and its effects on central nervous system inducing convulsion and post-operative behavioral changes.

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