Eichi Narimatsu

Publications (30)79.23 Total impact

• Article: Fatal upper airway obstruction induced by superior mediastinum bleeding.

  Eichi Narimatsu, Katsutoshi Tanno, Mamoru Hase, Yoshihiko Kurimoto, Yasufumi Asai
  American Journal of Emergency Medicine 06/2004; 22(3):246-7. · 1.98 Impact Factor
• Article: Tracheal intubation without neuromuscular relaxants for thymectomy in myasthenic patients.

  Eichi Narimatsu, Yuki Munemura, Mikito Kawamata, Hitoshi Imaizumi, Akiyoshi Namiki, Hiroshi Iwasaki
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  ABSTRACT: The purpose of the present study was to evaluate in detail the suitability of the combined use of fentanyl and propofol for endotracheal oral intubation without non-depolarizing muscle relaxants (NDMRs) for myasthenic patients. We evaluated orotracheal intubation, without using an NDMR, having induced anesthesia with 2 microg x kg(-1) fentanyl and 2.5 mg x kg(-1) propofol in myasthenic (Osserman's classification: I-IIb) and non-myasthenic patients. Using this technique, intubation was easily performed, the vocal cords remained opened, and any increase in blood pressure was satisfactorily suppressed in both myasthenic and non-myasthenic patients. In non-myasthenic patients, whose train-of-four ratio recorded immediately before intubation was 95-100%, a cough of moderate or severe intensity occurred. In myasthenic patients, no or only a slight cough occurred if the ratio was less than 75%, and a cough of moderate intensity occurred if the ratio was more than 90%. All of th coughing reflexes observed in myasthenic patients were considered to be clinically acceptable. The results indicate that the combined fentanyl and propofol technique, without NDMR, provides satisfactory intubatin conditions in myasthenic patients.
  Journal of medicine 02/2003; 34(1-6):47-58.
• Article: Experimental incision-induced pain in human skin: effects of systemic lidocaine on flare formation and hyperalgesia.

  Mikito Kawamata, Toshiyuki Takahashi, Yuji Kozuka, Yuko Nawa, Kohki Nishikawa, Eichi Narimatsu, Hiroaki Watanabe, Akiyoshi Namiki
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  ABSTRACT: In order to try to gain a better understanding of the mechanisms of post-operative pain, this study was designed to psychophysically determine physiological and pharmacological characteristics of experimental pain induced by a 4-mm-long incision through the skin, fascia and muscle in the volar forearm of humans. In experiment 1, the subjects (n=8) were administered lidocaine systemically (a bolus injection of 2mg/kg for a period of 5 min followed by an intravenous infusion of 2mg/kg/h for another 40 min), and then the incision was made. In experiment 2, cumulative doses of lidocaine (0.5-2mg/kg) were systemically injected in the subjects (n=8) 30 min after the incision had been made, when primary and secondary hyperalgesia had fully developed. Spontaneous pain was assessed using the visual analog scale (VAS). Primary hyperalgesia was defined as mechanical pain thresholds to von Frey hair stimuli (from 7 to 151 mN) in the injured area. The area of secondary hyperalgesia to punctate mechanical stimuli was assessed using a rigid von Frey hair (151 mN). Flare formation was assessed in the first experiment using a laser doppler imager (LDI). Pain perception was maximal when the incision was made and then rapidly disappeared within 30 min after the incision had been made. Primary hyperalgesia was apparent at 15 min after the incision had been made and remained for 2 days. The incision resulted in a relatively large area of flare formation immediately after the incision had been made. The area of flare began to shrink within 15 min and was limited to a small area around the injured area at 30 min after incision. Secondary hyperalgesia was apparent at 30 min after incision and persisted for 3h after incision and then gradually disappeared over the next 3h. In experiment 1, pre-traumatic treatment with systemic lidocaine suppressed primary hyperalgesia only during the first 1h after the incision had been made. The lidocaine suppressed the development of flare formation without affecting the pain rating when the incision was made. The development of secondary hyperalgesia continued to be suppressed after completion of the lidocaine infusion. In experiment 2, post-traumatic treatment with lidocaine temporarily suppressed primary as well as secondary hyperalgesia that had fully developed; however, the primary and secondary hyperalgesia again became apparent after completion of the lidocaine administration. These findings suggest that pre-traumatic treatment with lidocaine reduces the excessive inputs from the injured peripheral nerves, thus suppressing development of flare formation and secondary hyperalgesia through peripheral and central mechanisms, respectively. Pre-traumatic treatment with lidocaine would temporarily stabilize the sensitized nerves in the injured area, but the nerves would be sensitized after completion of the administration. Post-traumatic treatment with lidocaine reduced primary and secondary hyperalgesia that had fully developed. However, the finding that the suppressive effect of lidocaine on secondary hyperalgesia was temporary suggests that the development and maintenance of secondary hyperalgesia are caused by different mechanisms.
  Pain 12/2002; 100(1-2):77-89. · 5.78 Impact Factor
• Article: NMDA receptor-mediated mechanism of ketamine-induced facilitation of glutamatergic excitatory synaptic transmission.

  Eichi Narimatsu, Yurie Kawamata, Mikito Kawamata, Naoyuki Fujimura, Akiyoshi Namiki
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  ABSTRACT: The effect of ketamine on CA1-field EPSPs (fEPSPs) in rat hippocampal slices was investigated. Ketamine (100 microM) facilitated fEPSPs at 0.05 Hz. The fEPSP facilitation was suppressed completely by AP-5 and partially by propranolol, and also by an increase in stimulation frequency. These results indicate that ketamine facilitates excitatory synaptic transmission by activating NMDA receptors via beta-adrenoceptors under conditions in which NMDA receptor channel block is slight.
  Brain Research 11/2002; 953(1-2):272-5. · 2.73 Impact Factor
• Article: The first case report of stent-grafting for blunt extended aortic dissection.

  Yoshihiko Kurimoto, Kiyofumi Morishita, Nobuyoshi Kawaharada, Joji Fukada, Eichi Narimatsu, Yasufumi Asai, Tomio Abe
  The Journal of trauma 10/2002; 53(3):571-3. · 2.48 Impact Factor
• Article: Satisfactory recovery after 45 minutes of resuscitation in acute aortic dissection.

  Yoshihiko Kurimoto, Kiyofumi Morishita, Eichi Narimatsu, Yasufumi Asai, Tomio Abe
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  ABSTRACT: To report the satisfactory recovery of a woman with acute aortic dissection who underwent cardiopulmonary resuscitation out of hospital and to show that there are still chances of recovery for patients with prehospital cardiopulmonary arrest even due to acute aortic dissection. Case report. An adult critical care unit of a university hospital. A 71-yr-old woman who had a cardiopulmonary arrest out of hospital. Cardiopulmonary resuscitation was performed before arriving at the emergency room of our hospital. Cardiopulmonary resuscitation, echocardiography, computed tomography, aortography, coronary angiography, ascending aortic graft replacement, and brain hypothermia. Restoration of spontaneous circulation was gained 45 mins after onset of cardiopulmonary arrest. Echocardiographic and computed tomographic images revealed cardiac tamponade caused by type A acute aortic dissection. Since involuntary movements of the extremities in response to noxious stimulation were observed at 30 mins after restoration of spontaneous circulation, we performed an ascending aortic graft replacement and postoperative mild brain hypothermia. The patient recovered satisfactorily 1 month after the operation. The results of this case indicate that there are still chances of recovery for patients with prehospital cardiopulmonary arrest, even due to acute aortic dissection. We propose that an appearance of involuntary movements of the extremities in response to noxious stimulation is one key point that should be considered when deciding whether to perform an emergency operation for this kind of patient.
  Critical Care Medicine 10/2002; 30(9):2030-1. · 6.33 Impact Factor
• Article: [The use of propofol combined with nitrous oxide and fentanyl in anesthetic management of a patient with mitochondrial encephalomyopathy].

  Keisuke Shibukawa, Mikito Kawamata, Sumihiko Seki, Eichi Narimatsu, Akiyoshi Namiki
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  ABSTRACT: A 49-year-old female with mitochondrial encephalomyopathy underwent surgery for implantation of an artificial cochlear device. She had some characteristic clinical features, including muscle weakness, deafness and dementia. Anesthesia was induced with 5 mg.kg-1 of propofol, and the trachea was intubated without a muscle relaxant. The patient was mechanically ventilated also without a relaxant, and anesthesia was maintained with a continuous infusion of 4-8 mg.kg-1.hr-1 of propofol, a bolus injection of 50-100 micrograms of fentanyl, and nitrous oxide (66%) in oxygen (33%). Bispectral index (BIS) was monitored and maintained at approximately 40. No cardiovascular instabilities or increase in plasma lactate concentration were observed during surgery. The patient had a smooth recovery from the propofol anesthesia, and the BIS value returned to the pre-anesthetic level 10 min after completion of the anesthesia, suggesting that the use of propofol is a safe means for inducing and maintaining anesthesia in patients with mitochondrial encephalomyopathy.
  Masui. The Japanese journal of anesthesiology 09/2002; 51(8):888-91.
• Article: [Anesthesia for a patient with xeroderma pigmentosum].

  Yoshiki Masuda, Hitoshi Imaizumi, Mioko Okanuma, Eichi Narimatsu, Yasufumi Asai, Akiyoshi Namiki
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  ABSTRACT: The anesthetic management of a patient with xeroderma pigmentosum is described. A 17-year-old woman underwent tracheostomy because of progressive recurrent nerve palsy. The operation was performed uneventfully under general anesthesia using propofol and fentanyl. Xeroderma pigmentosum (XP) is an autosomal recessive disease that is characterized by hypersensitivity to sunlight with a high incidence of skin cancer and exhibits variable neurological abnormalities. Classical types of XP have a defect in nucleotide excision repair (NER). It has been reported that volatile anesthetics such as halothane deranged NER in cells obtained from an XP patient. Thus, general anesthesia using volatile agents should be avoided, if possible, because inhalation anesthetics may worsen the symptoms of XP.
  Masui. The Japanese journal of anesthesiology 03/2002; 51(2):169-71.
• Article: Onset of vecuronium neuromuscular blockade at the hand with an arterio-venous shunt

  Hiroshi Iwasaki, Masanori Yamauchi, Eichi Narimatsu, Michiaki Yamakage, Hideaki Tsuchida, Akiyoshi Namiki
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  ABSTRACT: PurposeTo evaluate the onset of vecuronium neuromuscular blockade in the hand with an arteno-venous shunt for haemodialysis. MethodsIn 15 adult patients receiving haemodialysis for renal failure the onset of vecuronium-induced neuromuscular blockade after 0.08 mg·kg−1 vecuroniumiv was measured. Using train-of-four mechanomyographic monitoring, the force of contraction of the adductor pollicis of both hands with and without arteno-venous shunt was measured simultaneously. ResultsThe times from the injection to the first depression of twitch response (latent onset) and 95% twitch depression (onset) in the hand with and without arteno-venous shunt were114.7 ± 33.4 and 218.7 ± 59.9 and 117.3 ± 34.3 and 208.7 ± 60.9 sec respectively. No difference in the onset of vecuronium neuromuscular blockade in the hand an arterio-venous shunt was demonstrated. ConclusionThe presence of an artenovenous fistula does not modify the onset on neuromuscular blockade. Either arm can be used to monitor onset of neuromuscular blockade in chronic renal failure patients with an arterio-venous shunt in the hand for haemodialysis ObjectifÉvaluer au niveau de la main l’installation du bloc neuromusculaire au vécuronium chez des porteurs d’un shunt arténoveineux intallé pour l’hémodialyse. MéthodesOn a mesuré chez 15 adultes hémodyalisés pour insuffisance rénale l’intallation du bloc neuromusculaire après l’administration de 0.08 mg·kgt-1 iv de vécuronium. Des moniteurs mécanomyographiques ont servi à mesurer le force de contraction de l’adducteur du pouce aux deux mains dont celle du shunt arténoveineux. RésultatsLes intervalles mesurés entre l’injection et la dépression du premier twicht (latence d’installation) et 95% (installation) avec et sans snunt artérioveineux étaient respectivement de 114,7 ± 33,4 et 218,7 ± 59,9 et 117,3 ± 34,3 et 208,7 ± 60,9 s. Lintallation du bloc neuromusculaire au vécuronium ne différait pas du côté shunt. ConclusionLa présence d’une fistule arténoveineuse ne modifie pas l’installation du bloc neuromusculaire. On peut utiliser indifféremment les deux bras pour le monitorage de l’intallation du bloc neuromusculaire chez les insuffisants rénaux chroniques porteur d’un shunt artérioveineux pour hémodialyse.
  Canadian Journal of Anaesthesia 10/1997; 44(11):1208-1210. · 2.35 Impact Factor
• Article: Preliminary report of contrast-enhanced computed tomography for patients with a percutaneous cardiopulmonary support system.

  Naoya Yama, Yoshihiro Takeyama, Katsutoshi Tanno, Satoshi Nara, Yasushi Itoh, Kazuhisa Mori, Mamoru Hase, Yoshihiko Kurimoto, Eichi Narimatsu, Kazumitsu Koito, Yasufumi Asai, Masato Hareyama
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  ABSTRACT: The purpose of this study was to investigate a suitable protocol of contrast-enhanced computed tomography (CECT) in cases with a cardiopulmonary support system. Contrast-enhanced computed tomography with intra-arterial injection (IAI) of contrast medium (CM) via a perfusion cannula showed sufficient contrast enhancement in 2 cases of cardiac decompensation (CD). Contrast-enhanced computed tomography with intravenous injection of CM showed insufficient and delayed contrast enhancement of the aorta in 2 cases of CD and 3 cases of pulseless electrical activity. We encourage administration of CM by means of IAI.
  Journal of Computer Assisted Tomography 29(6):760-4. · 1.22 Impact Factor