Centers & Services

Anesthesiology and Resuscitology Department

What is the Anesthesiology and Resuscitology Department?

Outpatient services of the Department of Anesthesiology and Resuscitology are divided into two prominent types: “outpatient service to evaluate a patient’s physical state before surgery for safe anesthesia and surgery (preoperative outpatient)” and “outpatient service to treat pain (Pain Center).”

Our physicians

Director, Anesthesiology and Resuscitology Department

Hiroshi Morimatsu, Professor
[Anesthesiology, Intensive Care Medicine]

Staff

Yoshimasa Takeda Associate professor (Intensive Care Division) [Anesthesiology, Intensive Care Medicine]
Kenji Sato Associate professor (Department of Resuscitology) [Anesthesiology, Pain Clinic]
Tatsuo Iwasaki Associate professor (Department of Pediatric Anesthesiology) [Anesthesiology, Intensive Care Medicine]
Motomu Kobayashi Lecturer (Perinatal Management Center) [Anesthesiology, Intensive Care Medicine]
Hiromi Fujii Assistant professor [Anesthesiology, Pain Clinic]
Hiroyuki Nishie Assistant professor [Anesthesiology, Pain Clinic]
Ryuji Kaku Assistant professor [Anesthesiology, Intensive Care Medicine, Pain Clinic]
Kazuyoshi Shimizu Assistant professor  
Takashi Matsusaki Assistant professor [Anesthesiology, Intensive Care Medicine]
Yoshikazu Matsuoka Assistant professor [Anesthesiology, Intensive Care Medicine]
Toshihiro Sasaki Assistant professor [Anesthesiology, Intensive Care Medicine]
Masao Hayashi Assistant professor [Anesthesiology, Intensive Care Medicine]
Tomoyuki Kanazawa Assistant professor [Anesthesiology, Intensive Care Medicine]
Kentaro Sugimoto Assistant professor [Anesthesiology, Intensive Care Medicine]
Satoshi Suzuki Assistant professor [Anesthesiology, Intensive Care Medicine]
Makiko Tani Assistant professor [Anesthesiology, Intensive Care Medicine, Medical Education]

*Specialty shown in [ ]

Weekly schedule of Pain Center outpatient service (outpatient service for pain): on the third floor of e dental outpatient block

  Monday Tuseday Wednesday Thursday Friday
AM PM AM PM AM PM AM PM AM PM
Pain outpatienty appointment) Hiromi Fujii No consultation No consultation Hiroyuki Nishie Liaison (Resuscitology) Orthopedic surgery
(Tomoko Tetsunaga)
Psychiatry / Neurology, Physical therapy etc.)
Ryuji Kaku
Ryuji Kaku Hiroyuki Nishie Takashi Matsusaki
  Kenji Sato        
Nerve block (fluoroscope-guided / by appointment) Hiromi Fujii Ryuji Kaku Ryuji Kaku Takashi Matsusaki   Hiromi Fujii Ryuji Kaku Takashi
Matsusaki
Ryuji Kaku Takas Matsus
First-visiting outpatient (only morning / by appointment) Ryuji Kaku         Hiroyuki Nishie   Ryuji Kaku Takashi Matsusaki  
Specialized outpatient
(by appointment)
  Virtual therapy   Shinichi Ishikawa   Liaison    

Weekly schedule of outpatient service of anesthesiology (preoperative outpatient service): on the fourth floor of the medical outpatient block

Monday Tuseday Wednesday Thursday Friday
Preoperative outpatient service Toshihiro Sasaki Motomu Kobayashi Takashi Matsusaki Yoshikazu Matsuoka Motomu Kobayashi

★ First-visiting and re-visiting outpatients are usually required to make an appointment in advance.

Preoperative outpatient service

In all operations conducted at Okayama University Hospital, except for locally infiltration anesthesia, the anesthesiologists are in charge of anesthetic procedures. Consequently, preoperative outpatient services target all of our patients.
Preoperative outpatient service is provided on the fourth floor of the medical outpatient block. The clinic days are Monday through Friday. The attending physicians or specialists of the Department of Anesthesiology provide treatments.
In the preoperative outpatient service, we examine the general condition of a patient so that anesthesia can be performed safely and properly for an operation. We perform perioperative management before and after surgery, striving to minimize the risks associated with operation and anesthesia. Based on the results of examinations conducted in each department, we judge whether the safety of operation or anesthesia can be maintained. Using blood tests, x-ray tests, and ultrasonography, we closely evaluate and examine the cardiopulmonary function and other complications. Based on these results, we make a perioperative plan that is judged as most appropriate for a patient and then clearly explain the contents and risks of anesthesia to the patient.
Please do not hesitate to ask about points you do not understand or concerns you might have about anesthesia.

Pain Center (outpatient service for pain)

The Pain Center provides treatments for all pain. At Okayama University Hospital, the Department of Anesthesiology and Resuscitology runs the Pain Center in collaboration with the Department of Dental Anesthesiology.
“Pain” functions as a caution signal indicating the abnormality occurring in the body. However, overly severe and long-lasting pain limits the quality or range of life for a patient. Pain lasting for three months or more is called chronic pain, which decreases the QOL so greatly that it is regarded as a social problem. The chronic pain is often coupled with psychological pain from inability to do work or housework, aside from physical pain from a wound or nerve. Therefore, we provide treatments for pain in cooperation with specialists in various fields.

Three divisions of the Pain Center at Okayama University Hospital


Pain Center outpatient sign-in desk


Dental Anesthesia Department's
consultation and treatment rooms

The Pain Center conducts pain examination, pain research, and new therapeutic development aiming to relieve a patient from all pain. The Pain Center includes three divisions.

  • Pain clinic: This division provides outpatient treatment for patients who have trouble with pain. We have the patients admitted to the hospital as needed.
  • Pain service: This division provides physicians to visit the ward and there provide treatments the patients, who are hospitalized with pain (intraoperative and postoperative pain, delivery with little pain, and cancer-related pain).
  • Pain research: This division identifies the causes of pain by research and develop new modalities of therapy.


    Outpatient waiting room

Treatment system

The Pain Center outpatient service moved to the third floor of the dental outpatient block in April 2012. The physicians belonging to the Department of Anesthesiology and Resuscitology and the Department of Dental Anesthesiology provide treatments.
“Pain liaison outpatient service” is a specialized outpatient service that is open in the afternoon on Thursday. Pain liaison outpatient service
The word liaison means “to connect.” The pain liaison outpatient service is offered so that patients suffering from chronic pain hand in hand with health-care professionals can set a goal and realize it.
The pain lasting for three months or more is called chronic pain, which wears out patients mentally and physically. The patients become mentally exhausted. They wonder why they must suffer. Under such circumstances, they cannot have good relations with their family members and friends. Over time, they gradually come to suffer from isolation, too. Ultimately, they want their pain to be taken away quickly, they strongly want to know why they feel pain, or they want to have unnecessary and excess examinations. In turn, the health-care professionals have no idea how to respond to them and become confused as well.
However, there is no need for pessimism. For such chronic pain, multimodality therapy is regarded as the most effective worldwide. Since April 2012, Okayama University Hospital has started a team consisting of anesthesiologists, orthopedists, clinical psychotherapists, psychiatrists, nurses, dental anesthesiologists, physical therapists, and occupational therapists, for improving the life of patients with chronic pain. The team supports you and your primary physician. You are not alone. Furthermore, although the team is not merely “to remove your pain”, we work hand in hand with others to devise a method for you to live better life. We first establish our goal, especially related to actions, such as “I will become able to do....” We collaborate to accomplish the goal. As we accomplish it little by little, you can live better life and expand your range. Then, your pain is gradually improved and you are likely to feel less pain.
The pain liaison outpatient service gives a patient treatment up to six months after a week hospital stay.
The pain liaison outpatient service provides treatments for the following patients:

  • who have troubles in their daily life caused by pain lasting for three months or more
  • who understand the meaning of the pain liaison outpatient service and hope to join it
  • who are referred to the service by the medical institute they visited within the past six months

Unfortunately, the service cannot give treatment to the following patients:


The pain liaison outpatient conference

  • who must receive other treatment in priority to our treatment
  • who are forbidden from undergoing rehabilitation
  • who are diagnosed with dementia or severe psychiatric disease
  • to whom our treatment is judged to be unsuited through conference because of other reasons

About how to visit the liaison pain outpatient service
Consent form of the liaison pain outpatient service

Treatment policy

At the first consultation, we take sufficient amounts of time to ask a patient about suffering aside from pain. Furthermore, for making a diagnosis we perform blood test, x-ray, CT, and MRI as needed. Our therapeutic approaches include nerve block therapy, pharmacological therapy, and rehabilitation therapy, among which we individualize the treatment policy for each patient. Additionally, we examine pain comprehensively in close cooperation with each department.

Specialties


Special fluoroscopy-guided nerve block

The Pain Center specializes in the following treatments:

  • Postoperative pain relief
  • Delivery with little pain
  • Nerve block for trigeminal neuralgia
  • Nerve block for chronic head and neck pain/back and leg pain caused by spinal cord-related diseases
  • Spinal epidural stimulation electrode for chronic pain
  • Pain liaison (multimodal pain) outpatient service for chronic pain
  • Virtual reality therapy for phantom limb pain/refractory neuropathic pain
  • Nerve block for cancer-related pain

Scope of target diseases

The “pain examination” in the Pain Center includes the following. Please contact the department if you have any questions.

  • Systemic illness: postherpetic neuralgia, diabetic neuropathy, postsurgical pain, cancer-related pain, myofascial pain syndrome, etc.
  • Head and neck pain: functional headache, trigeminal neuralgia, spine-related diseases (intervertebral disc hernia), traumatic head and neck syndrome, postherpetic neuralgia, thalamic pain, etc.
  • Shoulder and arm pain: spine-related diseases (cervical spondylotic radiculopathy), scapulohumeral periarthritis, stiff shoulders, thoracic outlet syndrome, phantom limb pain, injury to the brachial plexus, ischemic disease (arteriosclerosis obliterans), etc.
  • Chest, abdomen, and back pain: thoracic postoperative syndrome, spine-related disease (thoracic vertebra intervertebral joint symptoms, etc.), intercostal neuralgia, chronic pancreatitis, etc.
  • Back and leg pain: spine-related diseases (intervertebral disc hernia, lumbar canal stenosis, etc.), sacroiliac disease, compressed fracture, hip osteoarthritis, knee osteoarthritis, peripheral vascular diseases (Buerger’s disease and others), perineal pain, etc.

Description of medical care

After taking sufficient time for a medical interview, we use the interview sheet for diagnosis and search for the cause of pain. By adding necessary tests such as CT and MRI, we are able to provide treatments.
We have a good track record of nerve block therapy and perform it actively considering the indications.
Additionally, we offer pharmacological therapy suitable for pain, physical therapy in cooperation with the rehabilitation department, and the approach for psychologically or socially caused pain, among which we individualize pain treatment for each patient. Additionally, we have hospitalized to care system to meet the necessity of treatments.

For outpatients

The Pain Center is situated on the third floor of the dental outpatient block. The clinic service for both first-visiting and re-visiting outpatients requires appointment in advance. Please have your home doctor connect the General Patient Support Center to make an appointment if you visit the hospital for the first time. Furthermore, bring the referral with yourself.
When you change your appointment or have any question, please connect the Pain Center.
(Direct line to the sign-in desk: 086-235-7955)

Highly advanced/specialized medical treatment


Eco-guided nerve block


X-ray-guided nerve block

Techniques covered by health insurance programs

  • Epidural spinal cord stimulation electrode
    Electrodes to give an electric stimulus are inserted into epidural space to relieve pain. First, one-to-two-week trial stimulation is performed. When the effect is seen, we will consider implanting the electrodes so that they can relieve pain for a long time.
  • Echo-guided nerve block
    Seeing the nerve on the screen with ultrasonography, we perform nerve block. Compared with the conventional method, the new one has no exposure of radiation, improving the safety and certainty.
  • X-ray guided nerve block
    The Pain Center has an operation room dedicated for x-ray guided nerve block. There, we can perform reliable treatments fluoroscopically.
  • CT-guided nerve block
    To do difficult nerve block safely and surely, we collaborate with physicians from the Department of Radiology.

Techniques notified as highly advanced medical treatment

  • Epidural endoscopy (epiduroscopy)
    In therapy for lower back and leg pain, an ultrafine endoscope is inserted into epidural space to exfoliate nerve or adhesion.

Techniques performed in clinical research (approved by Okayama University’s ethical committee)

  • Virtual-reality-applied-scope therapy
    Virtual reality technology is used for treatments for unrelenting pain of extremity such as phantom limb pain or complex regional pain syndrome (CRPS).
  • Identification of biomarkers that can measure pain objectively with genome informatics
  • Effect of multimodality therapy (of the pain liaison outpatient service) for chronic pain

Main methods used for testing and explanation

The Pain Center performs the following tests:

  • Plain x-ray test
  • CT test (plain/contrast enhanced)
  • MRI test (plain/contrast enhanced)
  • Drug challenge test: some analgesics with different action mechanism are administered to deduce the cause of pain. It requires admission to hospital in principle.
  • Pain vision: it is a device to measure pain in a quantitative way.
  • Interview sheet: degree of pain, QOL, and psychological effects are rated numerically, requiring about 20 min.

Medical equipment


Outpatient treatment

When moved to the present floor, the Pain Center’s four beds in a treatment room were divided into four separate rooms. Since that time, we have been able to provide treatments for patients while keeping their privacy in mind; after treatment, they can rest comfortably

Treatment in an operation room

  • X-ray-guided nerve block: we perform nerve blocks fluoroscopically. Typical nerve blocks include trigeminal nerve block, radicular block, facet block, and lumbar sympathetic ganglion block.
  • Radiofrequency thermocoagulation: radiofrequency thermocoagulation nerve block is performed for long-term effects after confirming the effect with regional anesthesia. The best indication is found in chronic cervical spine pain and lumbar pain deriving from intervertebral joint. Additionally, it is applied to trigeminal block and lumbar sympathetic ganglion block.

Treatment in an operation room

  • CT-guided nerve block: CT-guided nerve block, such as celiac plexus block, is performed in the CT room.