Papers - Ihara, Naho

Altered functional connectivity associated with time discounting in chronic pain

Wakaizumi K., Jabakhanji R., Ihara N., Kosugi S., Terasawa Y., Morisaki H., Ogaki M., Baliki M.N.

Scientific Reports (Scientific Reports)  9 ( 1 )  2019.12

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Chronic pain (CP) is a global problem extensively associated with an unhealthy lifestyle. Time discounting (TD), a tendency to assign less value to future gains than to present gains, is an indicator of the unhealthy behaviors. While, recent neuroimaging studies implied overlapping neuro mechanisms underlying CP and TD, little is known about the specific relationship between CP and TD in behavior or neuroscience. As such, we investigated the association of TD with behavioral measures in CP and resting-state brain functional network in both CP patients and healthy subjects. Behaviorally, TD showed a significant correlation with meaningfulness in healthy subjects, whereas TD in patients only correlated with pain intensity. We identified a specific network including medial and dorsolateral prefrontal cortex (PFC) in default mode network (DMN) associated with TD in healthy subjects that showed significant indirect mediation effect of meaningfulness on TD. In contrast, TD in patients was correlated with functional connectivity between dorsolateral PFC (DLPFC) and temporal lobe that mediated the effect of pain intensity on TD in patients. These results imply that TD is modulated by pain intensity in CP patients, and the brain function associated to TD is shifted from a medial to lateral representation within the frontal regions.

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Effects of prophylactic dexamethasone on postoperative nausea and vomiting in scoliosis correction surgery: a double-blind, randomized, placebo-controlled clinical trial

Wakamiya R., Seki H., Ideno S., Ihara N., Minoshima R., Watanabe K., Sato Y., Morisaki H.

Scientific Reports (Scientific Reports)  9 ( 1 )  2019.12

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Dexamethasone is widely used for postoperative nausea and vomiting (PONV) prophylaxis, but its effect on PONV prevention in paediatric patients is validated only in short minor surgical procedures. In this study, we aimed to determine whether a single dose of dexamethasone reduces PONV in highly invasive surgeries that require opioid-based postoperative analgesia. One hundred adolescents undergoing scoliosis correction surgery were randomized to receive intravenous dexamethasone 0.15 mg/kg (dexamethasone group) or saline (control group) at induction of anaesthesia. The primary outcome was the incidence of PONV in the 72 h postoperatively. Data for 98 patients were available for analysis. The 72-h incidence of PONV was significantly lower in the dexamethasone group than in the control group (62.5% vs 84.0%; RR 0.74, 95% CI 0.58–0.96, P = 0.02). During the first and second 24-h postoperative intervals, fewer patients in the dexamethasone group received rescue antiemetics. Visual analogue scale scores for nausea and pain were lower in the dexamethasone group than in the control group during the first 24 h postoperatively. Dexamethasone did not increase the number of adverse events. The results of this study showed that a single dose of dexamethasone was effective for reducing PONV after paediatric scoliosis correction surgery.

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Aberrant resting-state functional connectivity of the dorsolateral prefrontal cortex to the anterior insula and its association with fear avoidance belief in chronic neck pain patients

Ihara N., Wakaizumi K., Nishimura D., Kato J., Yamada T., Suzuki T., Hashiguchi S., Terasawa Y., Kosugi S., Morisaki H.

PLoS ONE (PLoS ONE)  14 ( 8 )  2019.08

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Chronic neck pain (CNP), a global health problem, involves a large amount of psychological and socioeconomic burdens. Not only physical causes but also behavioral disorders such as a fear-avoidance belief (FAB) can associate with the chronicity of neck pain. However, functional brain mechanisms underlying CNP and its related behavioral disorders remain unknown. The aim of the current resting-state functional magnetic resonance imaging (fMRI) study was to explore how the functional brain networks differed between CNP patients and age- and sex-matched healthy, pain-free controls (HCs). We also investigated whether these possible brain network changes in CNP patients were associated with fear avoidance belief (FAB) and the intensity of pain. We analyzed the resting-state fMRI data of 20 CNP patients and 20 HCs. FAB and the intensity of pain were assessed by Tampa Scale for Kinesiophobia (TSK) and Visual Analog Scale (VAS) of pain. The whole brain analysis showed that CNP patients had significant different functional connectivity (FC) compared with HCs, and the right dorsolateral prefrontal cortex (DLPFC) was a core hub of these altered functional networks. Furthermore, general linear model analyses showed that, in CNP patients, the increased FC between the right DLPFC and the right anterior insular cortex (aIC) significantly associated with increased TSK (p = 0.01, statistical significance after Bonferroni correction: p<0.025), and the FC between the right DLPFC and dorsal posterior cingulate cortex had a trend of inverse association with VAS (p = 0.04). Our findings suggest that aberrant FCs between the right DLPFC and aIC associated with CNP and its related FAB.

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らくらくイメージ！呼吸レクチャー

Ihara Naho

オペナーシング 34   8 - 48 2019

Single Work

がん患者の痛みの管理

Ihara Naho

耳喉頭頸 90   564 - 571 2018.06

Pain management for head and neck cancer

Ihara N.

Otolaryngology - Head and Neck Surgery (Japan) (Otolaryngology - Head and Neck Surgery (Japan))  90 ( 7 ) 564 - 571 2018.06

ISSN  09143491

オピオイド使用患者の術前オピオイド使用量に応じた術後痛管理の有効性と安全性についての検討―前向き観察研究―

Ihara Naho

麻酔 67   351 - 355 2018.05

Research paper (scientific journal), Joint Work, Accepted

Efficacy and safety of equi-analgesic opioid conversion-based postoperative pain management for patients with chronic opioid use

Ihara N., Kosugi S., Wakaizumi K., Fukuda Y., Nishimura D., Yamada T., Hashiguchi S., Morisaki H.

Japanese Journal of Anesthesiology (Japanese Journal of Anesthesiology)  67 ( 4 ) 350 - 355 2018.04

ISSN  00214892

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Background: Few prospective study examined the optimal postoperative opioid dose setting for chronically opioid consuming patients. We prospectively investigated whether postoperative pain control based on the equianalgesic conversion of the preoperative opioid dose is a safe and adequate way of relieving postoperative pain in patients with chronic opioid use. Methods: The patients were allocated into the high dose group (HG) or the low dose group (LG) according to their preoperative doses of opioid. After surgery, the patients received intravenous morphine using a patient-controlled analgesia (PCA) pump which was set based on their preoperative opioid dose. The numerical rating scale (NRS) pain score, 24 hr cumulative morphine consumption, and the incidence of adverse events were compared between the groups. Results: A total of seventeen patients (HG I n=9, LG; n=8) were enrolled. The worst NRS pain score was significantly higher in HG than in LG. No serious adverse events due to overdose occurred in either group. Conclusions: Our PCA regimen appears to be safe overall; however it is still inadequate for relieving postoperative pain in patients taking high preoperative opioid doses.

術室の薬剤 サクッとはや調べTIPS 30 ②麻薬性・非麻薬性鎮痛薬．

Ihara Naho

オペナーシング 32   311 - 314 2017.02

術後鎮痛のためのPCA法の理解と管理や患者への指導のポイント

Ihara NahoHashiguchi Saori

消化器最新看護 21 ( 5 ) 3 - 9 2016.12

ベーシック特集　モニター・モニタリングのきほん これだけレクチャー　前編 各モニターの装着ができるようになろう！

Ihara Naho

オペナーシング 31   8 - 25 2016.07

Perioperative pain management in a patient using preoperative oxycodone : a case report

Ihara NahoShizuko Kosugi(/)-RSaori HashiguchiRie Wakamiya(/)-RDaisuke NishimuraHiroshi Morisaki

Journal of Japan Society of Pain Clinicians 23 ( 1 ) 25 - 28 2016.02

Research paper (scientific journal), Joint Work, Accepted