研究者詳細 - 若泉　謙太

論文 - 若泉　謙太

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Association of work performance and interoceptive awareness of 'body trusting' in an occupational setting: A cross-sectional study

Tanaka C., Wakaizumi K., Kosugi S., Tanaka S., Matsudaira K., Morisaki H., Mimura M., Fujisawa D.

BMJ Open （BMJ Open） 11 （ 5 ） e044303 2021年05月

査読有り

Objectives Work performance has been known to be influenced by both psychological stress (mind) and physical conditions (body). The aim of this study was to investigate the association between work performance and 'body trusting', which is a dimension of interoceptive awareness representing mind-body interactions. Methods A cross-sectional study was conducted among a sample of workers in an industrial manufacturing company in Japan. Participants were assessed with a self-reported questionnaire including evaluations of work performance, body trusting, psychological distress, pain persistence, workplace and home stressors, and workaholism. Participants' sociodemographic, health and lifestyle characteristics were collected from their annual health check data. The association between work performance and body trusting was examined using multivariable regression analyses in the overall sample and in a subsample of people with pain. Results A total of 349 workers participated in the study. A significant association between work performance and body trusting was observed, with higher body trusting representing higher work performance. The association was significant after controlling for psychological distress, workplace and home stress, workaholism and participants' characteristics (p<0.001). Compared with people without pain (n=126, 36.1%), people with pain (n=223, 63.9%) showed less body trusting, which was associated with decreased work performance after controlling for pain-related variables (p<0.001). Conclusions Workers with higher body trusting showed higher work performance, even after controlling for various influencing factors. Body trusting may be an important target to promote work performance and to prevent loss of performance induced by health problems.

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Antenatal pain, intimate partner violence, and maternal bonding disorder: data from the Japan Environment and Children's Study

Yamada K., Kimura T., Cui M., Kubota Y., Tanaka E., Wakaizumi K., Ikehara S., Kimura T., Iso H.

Pain （Pain） 162 （ 3 ） 749 - 759 2021年03月

査読有り

ABSTRACT: This prospective study examined (1) whether antenatal pain is associated with postnatal maternal bonding disorder (MBD) through postnatal depression and (2) whether intimate partner violence (IPV) has a moderating effect on the association between antenatal pain and postnatal MBD. We analyzed 77,326 pregnancies of women who completed self-report questionnaires including the SF-8 bodily pain item, the Edinburgh Postnatal Depression Scale, the Mother-to-Infant Bonding Scale, and an assessment of IPV. We conducted a mediation analysis to assess whether postnatal depression mediated the association between antenatal pain and MBD 1 year after delivery. A moderated mediation model was used to examine the conditional effect of IPV during pregnancy on the association between antenatal pain and postnatal MBD, operating through postnatal depression. All analyses were adjusted for demographic factors, socioeconomic factors, perinatal and infant factors, medical history, and psychological status. Of the 77,326 pregnancies, 5420 (7.0%) were characterized by persistent moderate-to-severe pain. The total effect of antenatal pain on MBD was significant (standardized path coefficient = 0.06, 95% confidence interval, 0.05-0.06) and postnatal depression dominantly mediated the association between antenatal pain and postnatal MBD (70.8% mediation). Contrary to our hypothesis, IPV during pregnancy did not moderate the association between antenatal pain and postnatal MBD. However, IPV during pregnancy did have independent negative effects on both postnatal depression and MBD. Our findings suggest that antenatal pain and postnatal depression should be assessed and treated with consideration of the presence of IPV during pregnancy to better monitor and prevent the development of MBD.

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Reorganization of functional brain network architecture in chronic osteoarthritis pain

Barroso J., Wakaizumi K., Reis A.M., Baliki M., Schnitzer T.J., Galhardo V., Apkarian A.V.

Human Brain Mapping （Human Brain Mapping） 42 （ 4 ） 1206 - 1222 2021年03月

査読有り, ISSN 10659471

Osteoarthritis (OA) manifests with chronic pain, motor impairment, and proprioceptive changes. However, the role of the brain in the disease is largely unknown. Here, we studied brain networks using the mathematical properties of graphs in a large sample of knee and hip OA (KOA, n = 91; HOA, n = 23) patients. We used a robust validation strategy by subdividing the KOA data into discovery and testing groups and tested the generalizability of our findings in HOA. Despite brain global topological properties being conserved in OA, we show there is a network wide pattern of reorganization that can be captured at the subject-level by a single measure, the hub disruption index. We localized reorganization patterns and uncovered a shift in the hierarchy of network hubs in OA: primary sensory and motor regions and parahippocampal gyrus behave as hubs and insular cortex loses its central placement. At an intermediate level of network structure, frontoparietal and cingulo-opercular modules showed preferential reorganization. We examined the association between network properties and clinical correlates: global disruption indices and isolated degree properties did not reflect clinical parameters; however, by modeling whole brain nodal degree properties, we identified a distributed set of regions that reliably predicted pain intensity in KOA and generalized to hip OA. Together, our findings reveal that while conserving global topological properties, brain network architecture reorganizes in OA, at both global and local scale. Network connectivity related to OA pain intensity is dissociated from the major hub disruptions, challenging the extent of dependence of OA pain on nociceptive signaling.

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言語的妥当性を担保した日本語版Injustice Experience Questionnaire-Short Formの作成

山田恵子, 若泉謙太, 壬生彰, 向後響, 井関雅子, 西上智彦

ペインクリニック（真興交易(株)医書出版部） 42 （ 2 ） 239 - 244 2021年02月

ISSN 0388-4171

疼痛患者の抱える「不公平感」は症状の遷延や重篤化につながる。今回、12項目から構成される不公平感質問票を、より簡便に利用できるように開発された短縮版不公平感質問票(Injustice Experience Questionnaire-Short Form:IEQ-SF)の言語的妥当性を担保した日本語版を作成した。IEQ-SFは5つの質問項目と3つの選択肢から構成される。言語的に妥当な尺度の翻訳版を作成するための国際的なガイドライン、およびIEQ-SFの著作権管理会社が定めるガイドラインに準拠した手続きを経て、国際比較研究に使用できる水準の日本語版が作成できた。(著者抄録)

Sitting for long periods is associated with impaired work performance during the COVID-19 pandemic

Wakaizumi K., Yamada K., Shimazu A., Tabuchi T.

Journal of Occupational Health （Journal of Occupational Health） 63 （ 1 ） e12258 2021年01月

筆頭著者, 責任著者, ISSN 13419145

Objectives: The unprecedented coronavirus disease 2019 (COVID-19) pandemic and the corresponding government state of emergency have dramatically changed our workstyle, particularly through implementing teleworking and social distancing. We investigated the degree to which people's work performance is affected and the association between sedentary behavior under the state of emergency and worsened work performance during the COVID-19 pandemic, as previous studies have suggested that sedentary behavior decreases work performance. Methods: We used data from the Japan “COVID-19 and Society” Internet Survey (JACSIS) study, a cross-sectional, web-based, self-reported questionnaire survey. The main outcome was change in work performance after the COVID-19 pandemic compared with that before the pandemic. We analyzed the association between the change in work performance and sitting duration under the state of emergency, adjusted for work-related stress, participants’ demographics, socio-economic status, health-related characteristics, and personality. Results: The change of work environment from the pandemic decreased work performance in 15% of workers, which was 3.6 times greater than the number of workers reporting increased performance in 14 648 workers (6134 women and 8514 men). Although telework both improved and worsened performance (odds ratio [OR], 95% confidence interval [CI] = 2.0, 1.6-2.5 and 1.7, 1.5-1.9, respectively), sitting for long periods after the state of emergency was significantly associated only with worsened performance (OR, 95% CI = 1.8, 1.5-2.2) in a dose–response manner. Conclusion: Sitting duration is likely a risk barometer of worsened work performance under uncertain working situations, such as the COVID-19 pandemic.

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Momentary pain assessments reveal benefits of endoscopic discectomy: a prospective cohort study

Wakaizumi K., Wu B., Huang S., Fan L., Shen B., Wu B., Zhang J., Baliki M.N., Apkarian A.V., Huang L.

Pain Reports （Pain Reports） 6 （ 1 ） e906 2021年

筆頭著者, 査読有り

Introduction:Lumbar disc herniation (LDH) is a common back disorder that evokes back and/or leg pain. Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive surgery for patients with LDH. However, there is little evidence of effectiveness of PELD compared with conservative treatments.Objective:The goal of this study was to quantify the efficacy of PELD compared with conservative treatments.Methods:Here, we conducted a prospective observational cohort study using momentary pain assessments via a smartphone app during 3 months following surgery. The trajectories of daily ecological momentary pain assessments were fitted with an exponential model containing two parameters: a pain reduction coefficient and the percentage of persistent pain. To control for selection bias between PELD and Conservative groups (N = 167 and 34), we used inverse probability (IP) of treatment weighting for statistical comparisons.Results:Compared with conservative treatments, both momentary pain rating and the exponential model showed statistically significant pain recovery following PELD (p < 0.001). In addition, PELD had a faster pain recovery rate (hazard ratio (95% confidence interval): 1.75 (1.40, 2.20), p < 0.001), greater overall pain recovery rate (odds ratio (95%CI): 2.35 (2.01, 5.26), p < 0.001), faster pain reduction (t199= 3.32, p = 0.001), and lower estimated persistent pain (Z = 2.53, p = 0.011). Greater pain intensity and lower anxiety before the surgery were predictors of faster pain reduction in the recovery subgroup following PELD.Conclusions:In conclusion, momentary pain rating and the model fitting revealed that PELD provided rapid pain recovery that lasted for at least three months. Greater pain intensity and lower anxiety before the surgery were predictors of faster pain reduction in the recovery subgroup following PELD. Daily momentary pain rating on a smartphone may be able to provide more informative data to evaluate effect of an intervention than pain assessment on hospital visits.

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【運動器の痛み:どこから来るのか?どこへ行くのか?】(Part1)運動器の痛みどこから来るのか? 慢性腰痛の病態

松平浩, 吉本隆彦, 若泉謙太, 唐司寿一, 笠原諭

Bone Joint Nerve （(株)アークメディア） 10 （ 4 ） 561 - 568 2020年10月

ISSN 2186-1110

慢性疼痛患者分類として質問票スコアにクラスター分析を用いた手法と、国際疾病分類第11版(ICD-11)に基づく分類の関連

河合愛子, 山田恵子, 濱岡早枝子, 千葉聡子, 若泉謙太, 山口敬介, 井関雅子

PAIN RESEARCH （(一社)日本疼痛学会） 35 （ 3 ） 141 - 153 2020年09月

査読有り, ISSN 0915-8588

クラスター分析による慢性疼痛患者分類と国際疾病分類第11版(ICD-11)の慢性疼痛分類を用いた患者分類の関連を分析した。初診時点で痛みの持続期間が3ヵ月以上の慢性疼痛患者229名を対象とした。Two-Stepクラスター分析によって、最適クラスター数は3個であると判定された。ICD-11慢性疼痛分類の大分類ごとの各クラスターが占める割合について、全体のクラスター分布に有意な差があったが、ICD-11慢性疼痛分類の大分類ごとの個別クラスターの割合に統計的有意差はなかった。慢性筋骨格系痛全体を占める重症クラスターの割合と比較して、慢性内臓痛全体を占める重症クラスターの割合が高かった。それ以外の疾患分類については、各疾患分類全体を占める重症クラスターの割合は17.6%から45.5%であり、慢性筋骨格系痛全体を占める重症クラスターの割合と比較して高い傾向であった。クラスター分類は一部のICD-11慢性疼痛分類との関連で臨床的経験やガイドラインの内容と一致する結果であった。

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Pain medications during pregnancy: data from the Japan environment and children’s study

Yamada K., Kimura T., Ikehara S., Cui M., Kubota Y., Wakaizumi K., Takeda T., Iso H.

Journal of Anesthesia （Journal of Anesthesia） 34 （ 2 ） 202 - 210 2020年04月

査読有り, ISSN 09138668

Purpose: Analgesic medication epidemic during pregnancy is an important issue in Western countries. However, no large epidemiological study involving pregnant women with pain and their medication use has been conducted in Japan. This study examined the current situation of medication use for non-cancer pain during the perinatal period in Japan using national cohort data. Methods: We analyzed 94,649 pregnant women who completed a self-report questionnaire investigating bodily pain and an interview-based medication use survey. Medication use before and during pregnancy and new medication administration/discontinuation during pregnancy were compared between women with and without pain during pregnancy using multivariable covariance analysis. Results: Mild pain was reported by 50.4% of pregnant women in the first trimester (survey 1) and 61.8% in the second/third trimester (survey 2). Moderate-to-severe pain was reported by 15.4% of women in survey 1 and 22.4% in survey 2. In survey 1, 6.2% of women used prescribed analgesics and 1.6% used over-the-counter analgesics. In survey 2, prescribed and over the counter analgesics were used by 12.2% and 0.8% of women, respectively. Other pain-related medications were rarely used (< 1.0%). Pregnant women with moderate-to-severe pain showed a lower proportion of discontinuation of analgesics and a higher proportion of new administration of prescription and transdermal analgesics compared with those without pain. Conclusions: Although a large proportion of pregnant women experience pain, medication use for pain during pregnancy is low in Japan compared with Western countries (50–60%). Adequate treatment or support may be necessary for pregnant women experiencing pain in Japan.

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Prediction of postoperative pain and opioid requirement in patients chronically using opioids

Naho Ihara, Shizuko Kosugi, Kenta Wakaizumi, Daisuke Nishimura, Yoko Fukuda, Hiromasa Nagata, Takashige Yamada, Saori Hashiguchi, Hiroshi Morisaki

JOURNAL OF CLINICAL ANESTHESIA （ELSEVIER SCIENCE INC） 60 14 - 15 2020年03月

筆頭著者, 査読有り, ISSN 0952-8180

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【慢性痛へのアプローチ】痛みと脳

若泉謙太

最新精神医学（(株)世論時報社） 25 （ 2 ） 73 - 84 2020年03月

筆頭著者, ISSN 1342-4300

Prognostics for pain in osteoarthritis: Do clinical measures predict pain after total joint replacement?

Barroso J., Wakaizumi K., Reckziegel D., Pinto-Ramos J., Schnitzer T., Galhardo V., Apkarian A.V.

PLoS ONE （PLoS ONE） 15 （ 1 ） e0222370 2020年01月

査読有り, ISSN 1932-6203

A significant proportion of osteoarthritis (OA) patients continue to experience moderate to severe pain after total joint replacement (TJR). Preoperative factors related to pain persistence are mainly studied using individual predictor variables and distinct pain outcomes, thus leading to a lack of consensus regarding the influence of preoperative parameters on post-TJR pain. In this prospective observational study, we evaluated knee and hip OA patients before, 3 and 6 months post-TJR searching for clinical predictors of pain persistence. We assessed multiple measures of quality, mood, affect, health and quality of life, together with radiographic evaluation and performance-based tasks, modeling four distinct pain outcomes. Multivariate regression models and network analysis were applied to pain related biopsychosocial measures and their changes with surgery. A total of 106 patients completed the study. Pre-surgical pain levels were not related to post-surgical residual pain. Although distinct pain scales were associated with different aspects of post-surgical pain, multi-factorial models did not reliably predict post-surgical pain in knee OA (across four distinct pain scales) and did not generalize to hip OA. However, network analysis showed significant changes in biopsychosocial-defined OA personality post-surgery, in both groups. Our results show that although tested clinical and biopsychosocial variables reorganize after TJR in OA, their presurgical values are not predictive of post-surgery pain. Derivation of prognostic markers for pain persistence after TJR will require more comprehensive understanding of underlying mechanisms.

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Psychology, psychiatry, imaging and brain neuroscience section Structural MRI Analysis of chronic pain patients following interdisciplinary treatment shows changes in brain volume and opiate-dependent reorganization of the amygdala and hippocampus

Gagnon C.M., Scholten P., Atchison J., Jabakhanji R., Wakaizumi K., Baliki M.

Pain Medicine (United States) （Pain Medicine (United States)） 21 （ 11 ） 2765 - 2776 2020年

査読有り, ISSN 15262375

Objective. The present study examined pre-to post-treatment changes in volumes for brain structures known to be associated with pain processing (thalamus, caudate, putamen, pallidum, hippocampus, amygdala, and accumbens) following an interdisciplinary pain management program. Design. Twenty-one patients participating in a four-week interdisciplinary pain management program completed the study. The program consisted of individual and group therapies with the following disciplines: Physical therapy, occupational therapy, pain psychology, biofeedback/relaxation training, nursing lectures, and medical management. All patients underwent functional magnetic resonance imaging of the brain before the start and at completion of the program. They also completed standard outcome measures assessing pain, symptoms of central sensitization, disability, mood, coping, pain acceptance, and impressions of change. Results. Our results showed a significant increase in total brain volume, as well as increased volumes in the thalamus, hippocampus, and amygdala. As expected, we also found significant improvements in our standard outcome measures. The majority of patients rated themselves as much or very much improved. The increase in volume in the hippocampus was significantly associated with patient perceptions of change. However, the correlations were in the unexpected direction, such that greater increases in hippocampal volume were associated with perceptions of less improvement. Further exploratory analyses comparing patients by their opioid use status (use vs no use) showed differential program effects on volume increases in the hippocampus and amygdala. Conclusions. These findings show that a four-week interdisciplinary pain management program resulted in changes in the brain, which adds objective findings further demonstrating program efficacy.

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Whole-brain functional network disruption in chronic pain with disk herniation

Huang S., Wakaizumi K., Wu B., Shen B., Wu B., Fan L., Baliki M.N., Zhan G., Apkarian A.V., Huang L.

Pain （Pain） 160 （ 12 ） 2829 - 2840 2019年12月

査読有り, ISSN 03043959

Brain functional network properties are globally disrupted in multiple musculoskeletal chronic pain conditions. Back pain with lumbar disk herniation (LDH) is highly prevalent and a major route for progression to chronic back pain. However, brain functional network properties remain unknown in such patients. Here, we examined resting-state functional magnetic resonance imaging-based functional connectivity networks in chronic back pain patients with clear evidence for LDH (LDH-chronic pain n = 146), in comparison to healthy controls (HCs, n = 165). The study was conducted in China, thus providing the opportunity to also examine the influence of culture on brain functional reorganization with chronic pain. The data were equally subdivided into discovery and validation subgroups (n = 68 LDH-chronic pain and n = 68 HC, for each subgroup), and contrasted to an off-site data set (n = 272, NITRC 1000). Graph disruption indices derived from 3 network topological measurements, degree, clustering coefficient, and efficiency, which respectively represent network hubness, segregation, and integration, were significantly decreased compared with HC, across all predefined link densities, in both discovery and validation groups. However, global mean clustering coefficient and betweenness centrality were decreased in the discovery group and showed trend in the validation group. The relationship between pain and graph disruption indices was limited to males with high education. These results deviate somewhat from recent similar analysis for other musculoskeletal chronic pain conditions, yet we cannot determine whether the differences are due to types of pain or also to cultural differences between patients studied in China and the United States.

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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 ） 8154 - 8154 2019年12月

査読有り, ISSN 2045-2322

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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Smoking is associated with greater pain intensity and pain-related occupational disability in Japanese workers

Yamada K., Wakaizumi K., Kubota Y., Matsudaira K., Shibata M.

Journal of Anesthesia （Journal of Anesthesia） 33 （ 4 ） 523 - 530 2019年08月

査読有り, ISSN 09138668

Purpose: Pain symptom, such as that caused by musculoskeletal disorders, is a major cause of occupational disability. As nicotine intake from smoking increases pain sensitivity, smokers may experience stronger pain and be more likely to experience pain-related disability than non-smokers. The study aim was to examine whether smoking was associated with pain-related occupational disability via pain intensity. Methods: Participants were 1189 workers with pain aged 20–74 years in Japan. Participants completed a self-report questionnaire, which included a question to measure pain-related occupational disability with ordinal-option: (1) without pain-related disability, (2) pain-related presenteeism, and (3) pain-related absenteeism. An ordinal logistic regression model was used to calculate multivariable-adjusted proportional odds ratios (OR) with 95% confidence intervals (CI) for the prevalence of pain-related occupational disability according to smoking status. A multiple mediation analysis was also conducted to assess whether pain sensitivity mediated the association between smoking and pain-related occupational disability. Adjusted variables were demographic variables, socioeconomic status, work-related psychosocial factors, general psychological factors, and pain duration. Results: Current smoking and pain were associated with pain-related occupational disability compared with non-smoking and pain (multivariable OR 1.78; 95% CI 1.26–2.52). Greater pain intensity partially mediated the association of current smoking and pain with pain-related occupational disability. The mediation rate (indirect/total effect) was 25%. Conclusion: Smoking and pain were associated with pain-related occupational disability, partially through greater pain intensity, among Japanese workers.

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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 ） e0221023 2019年08月

査読有り, ISSN 1932-6203

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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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年04月

ISSN 00214892

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.

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

伊原奈帆, 小杉志都子, 若泉謙太, 福田陽子, 西村大輔, 山田高成, 橋口さおり, 森崎浩

麻酔（克誠堂出版(株)） 67 （ 4 ） 350 - 355 2018年04月

査読有り, ISSN 0021-4892

術前オピオイド使用中の患者の使用量に応じた術後痛管理の有効性と安全性について、前向き観察研究を行った。2014年1月から2016年6月までの期間に、術前からオピオイドを使用していた予定手術患者を対象とし、経口モルヒネ換算60mg・day-1を超えるオピオイド使用患者を高用量群、60mg・day-1以下を低用量群とし、術後モルヒネ使用量、痛み、有害事象について比較した。高用量群(n=9)は低用量群(n=8)より術後モルヒネ使用量が多いにもかかわらず、術後痛が有意に強かった。有害事象の発生率に有意差はなかった。(著者抄録)

Study of chronic pain and its associated risk factors among Japanese industry workers: the Quality of Working Life Influenced by Chronic pain (QWLIC) study.

Keiko Yamada, Kenta Wakaizumi, Kyosuke Fukai, Hiroyasu Iso, Tomotaka Sobue, Masahiko Shibata, Ko Matsudaira

Sangyo eiseigaku zasshi = Journal of occupational health 59 （ 5 ） 125 - 134 2017年10月

査読有り

OBJECTIVES: This study was performed to identify the prevalence, influence, and risk factors associated with chronic pain among Japanese industry workers. METHODS: We investigated 2,544 participants working at a manufacturing company A, a manufacturing company B, and 16 branch shops of a retail chain company C. The participants responded to self-administered questionnaires related to pain. Furthermore, data obtained from the lifestyle interview sheet of an annual health screening examination and those obtained from the questionnaires were merged. We analyzed the association between lifestyles, psychosocial factors, and chronic pain. Age- and sex-adjusted odds ratios were calculated with a 95% confidence interval using the logistic regression model. RESULTS: Of 2,544 participants, 1,914 (1,224 men and 690 women) completed the questionnaire, and the response rate was 75.2%. The prevalence of chronic pain over 3 months was 42.7% and that of chronic pain with work disability was 11.3%. A higher proportion of obesity, smoking habit, insomnia, psychological stress, depressive state, workaholic nature, low social support from supervisors and coworkers, high job demand, low job control, and job dissatisfaction was observed in workers with chronic pain than in workers without pain. CONCLUSIONS: Several risk factors of chronic pain in Japanese industry workers were found. Obesity, smoking habits, sleep disorders, workplace environment, and mental state should be taken into account as risk factors associated with chronic pain issues and general occupational health.

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若泉 謙太

論文 - 若泉 謙太

若泉　謙太

論文 - 若泉　謙太