Tong-Joo Gan, MD

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• Anesthesiology

Vice Chair, Department of Anesthesiology

Department / Division:
Anesthesiology / Anesthesiology

Address:
DUMC 3094
Durham, NC 27710

Appointment Telephone:
(919) 681-4660

Office Telephone:
(919) 681-4660

Fax Telephone:
(919) 681-7901

• M.D., The London Hospital Medical College, 1987

• Anesthesia, University of London, 1988-1989
• Intensive Care, Middlesex Hospital, 1989-1990
• Anesthesia and Intensive Care, University College Hospital, 1990-1991
• Anesthesia and Intensive Care, Royal National Orthopedic Hospital, 1991-1992
• Anesthesia and Intensive Care, Royal Brompton Heart and Lungs Hospital, 1992-1993

Clinical Interests:
General anesthesiology, vascular and high risk anesthesiology, ambulatory anesthesiology, liver transplantation anesthesiology, acute pain

Research Interests:
My current areas of research interests include postoperative nausea and vomiting (PONV), acute postoperative pain, and clinical pharmacology of anesthetic drugs and resuscitation fluids.
Improving Outcome in Surgical Patients

Nausea and vomiting is regarded as one of the most unpleasant experiences in postoperative recovery. To date, there is no single antiemetic which can satisfactorily control PONV. My interests concentrate on the use of new and novel antiemetics, combination antiemetic therapy, as well as new mothods of delivery of these medications.

Another area of reserach interest is fluid resuscitation during surgery.  I have conducted a number of studies investigating the use of a new balanced colloid intraoperatively.  I am investigating the use of esophageal Doppler, a relatively non-invasive cardiac output monitor, as a guid for fluid loading during major blood loss surgery.

Improveing Quality of Recovery in Geriatric Patients

My previous experience with bispectral index monitoring has aroused my interest to pursue other clinical investigations in this area.  With the INtranational Anesthetic Research Society Clinical Scholar Award, I am investigating the recovery of elderly patients from day surgery with the use of bispectral index.

Much of what we do in anesthesia may not affect mortality and influence the lengtho f hopsital stay.  However, the quality of recovery, such as the avoidance of pain,  absense of postoperative nausea and vomiting can be prevented.  In the days of cost containment in health care, managed care companies may not be intersted in additional expenses that do not have an impact on the duration of hospital stay.  With new methodology, I am assessing patient's willingness to pay to avoid these postoperative discomforts.

Representative Publications:
Gan TJ, Sloan F, Dear G, El-Moalem H, Lubarsky DA. How much are patients willing to pay for avoidance of postoperative nausea and vomiting? Anesth Analg. 2001;92:393-400 (2001)

Gan TJ. Risk Assessment for the Management of Postoperative Nausea and Vomiting. Clinical Research 2001; 11:2-7. (2001)

Alexander R, Hill R, El-Moalem HE, Gan TJ. Remifentanil prevents the hemodynamic response to orotracheal intubation. J Applied Research 2001;1(2): December issue. (2001)

Gan TJ. Postoperative nausea and vomiting--can it be eliminated? JAMA. 2002 Mar 13;287(10):1233-6. (2002) Abstract

Habib AS, Gan TJ. Combination therapy for postoperative nausea and vomiting - a more effective prophylaxis? . 2001 Jul;9(2):59-71. (2001) Abstract

Schow AJ, Lubarsky DA, Olson RP, Gan TJ. Can succinylcholine be used safely in hyperkalemic patients? Anesth Analg. 2002 Jul;95(1):119-22, table of contents. (2002) Abstract

Gan TJ, Madan R, Alexander R, Jhaveri R, El-Moalem H, Weatherwax K, Glass PS. Duration of action of vecuronium after an intubating dose of rapacuronium, vecuronium, or succinylcholine. Anesth Analg. 2001 May;92(5):1199-202. (2001) Abstract

Gan TJ, Habib AS. Use of the bispectral index to monitor anaesthesia. Hosp Med. 2002 Feb;63(2):68-9. (2002) Abstract

Dexter F, Gan TJ, Naguib M, Lubarsky DA. Cost identification analysis for succinylcholine. Anesth Analg. 2001 Mar;92(3):693-9. (2001) Abstract

Brudney C, McCann R, Gan TJ. Comparison of open versus endovascular abdominal aortic aneurysm repair. Anesthesiology 2002; 97:A193 (2002)

Robertson KM, Gan TJ. Clinical research and good clinical practice.  Best Practice and Research Clinical Anesthesiology. Chapter 11. Edited by P.S. Myles. Published by Bailliere Tindall. 2002. (2002)

Gan TJ, Wright D, Somma J, McClurkin I.  Pentalyte, a novel middle molecular weight starch in balanced electrolyte solution. Anesthesiology 2002; 97:A440. (2002)

Breslin D, Jiao K, Ferrero D, Gan TJ. Pharmacodynamic interactions between neuromuscular blocking agents of the steroidal and benzo-isoquinolinium classes. Anesthesiology 2002; 97: A981. (2002)

Gan TJ, Joshi G, Viscusi E, Chen C, Cheung R. Postdischarge recovery experience after single presurgery dose of IV parecoxib sodium, a novel COX-2 inhibitor, followed by oral valdecoxib for pain after laparoscopic cholecystectomy. Anesthesiology 2002; 97: A20. (2002)

Habib AS, Gan TJ. Combination antiemetics: what is the evidence? Int Anesthesiol Clin. 2003 Fall;41(4):119-44. (2003) Abstract

Martin G, Glass PS, Breslin DS, MacLeod DB, Sanderson IC, Lubarsky DA, Reves JG, Gan TJ. A study of anesthetic drug utilization in different age groups. J Clin Anesth. 2003 May;15(3):194-200. (2003) Abstract

Gan TJ, Ing RJ, de L Dear G, Wright D, El-Moalem HE, Lubarsky DA. How much are patients willing to pay to avoid intraoperative awareness? J Clin Anesth. 2003 Mar;15(2):108-12. (2003) Abstract

Gan TJ. Preface. Int Anesthesiol Clin. 2003 Fall;41(4):XV-XVI. (2003) Abstract

Habib AS, Gan TJ. Food and drug administration black box warning on the perioperative use of droperidol: a review of the cases. Anesth Analg. 2003 May;96(5):1377-9. (2003) Abstract

Gan TJ, Meyer T, Apfel CC, Chung F, Davis PJ, Eubanks S, Kovac A, Philip BK, Sessler DI, Temo J, Tramèr MR, Watcha M, . Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg. 2003 Jul;97(1):62-71, table of contents. (2003) Abstract

Habib AS, Gan TJ. Pharmacotherapy of postoperative nausea and vomiting. Expert Opin Pharmacother. 2003 Apr;4(4):457-73. (2003) Abstract

Olson RP, Schow AJ, McCann R, Lubarsky DA, Gan TJ. Absence of adverse outcomes in hyperkalemic patients undergoing vascular access surgery. Can J Anaesth. 2003 Jun-Jul;50(6):553-7. (2003) Abstract

Shang AB, Gan TJ. Optimising postoperative pain management in the ambulatory patient. Drugs. 2003;63(9):855-67. (2003) Abstract

Cameron D, Gan TJ. Management of postoperative nausea and vomiting in ambulatory surgery. Anesthesiol Clin North America. 2003 Jun;21(2):347-65. (2003) Abstract

Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003 Aug;97(2):534-40, table of contents. (2003) Abstract

Gan, TJ. Evidence-based management of post-operative nausea and vomiting. Can J Anesth  2003;50:R1-R4. (2003)

McKinlay S, Gan TJ. Intra-abdominal operations. Section IV: Intravenous fluid therapy in daily practice, Chapter 3. Perioperative Fluid Therapy. Edited by Robert G. Hahn, MD, Ph.D. and Donald S. Prough, MD. Published by Marcel Dekker, Inc. 2003. (2003)

Deballi P, Gan TJ. The use of propofol as an antiemetic. International Anesthesiology Clinics: Postoperative Nausea and Vomiting. Edited by Tong Joo Gan. 2003;41:67-68. (2003)

Gan TJ. A 3-step guide to PONV prophylaxis: one expert's advice on how to prevent PONV. Outpatient Surgery Magazine. February 2003: 54-59. (2003)

Gan, TJ. Advice on postop nausea and vomiting. OR Manager. November 2003;19:25-28. (2003)

Gan TJ, Robertson K, Moretti E, Glass PSA. Dear BBC: It's the colloid, not the esophageal Doppler monitor. Anesthesiology 2003;99:239. (2003)

Habib A, Gan TJ. There should be a threshold dose for the FDA black-box warning on droperidol. Anesth Analg 2003;97:1542-43. (2003)

Barbieto A, Schultz J, Gan TJ, Muir H. ASA physical status classification in pregnant patients. Anesthesiology 2003;99:A1195 (2003)

Breslin D, Lubarsky D, Hopkins M, Gan TJ. Delayed discharge from the post anesthetic care unit. An ongoing improvement process. Anesthesiology 2003;99:A1305. (2003)

McKinlay S, Cameron D. Robertson K, Yang R, Gan TJ. Is Hextend® IV fluid therapy a risk factor for post-operative renal insufficiency in live kidney donors? Anesthesiology 2003;99:A501. (2003)

Robertson K, Soma J, Jiao K, Gan TJ, Cameron D. IV Hextend® during liver transplantation and its effect on postoperative coagulation and RBC transfusion requirements. Anesthesiology 2003;99:A157. (2003)

Wilkes NJ, Woolf RL, Powanda MC, Gan TJ, Machin SJ, Webb A, Mutch M, Bennett-Guerrero E, Mythen M. Hydroxyethyl starch in balanced electrolyte solution (Hextend)--pharmacokinetic and pharmacodynamic profiles in healthy volunteers. Anesth Analg. 2002 Mar;94(3):538-44; table of contents. (2002) Abstract

Martin G, Bennett-Guerrero E, Wakeling H, Mythen MG, El-Moalem H, Robertson K, Kucmeroski D, Gan TJ. A prospective, randomized comparison of thromboelastographic coagulation profile in patients receiving lactated Ringer's solution, 6% hetastarch in a balanced-saline vehicle, or 6% hetastarch in saline during major surgery. J Cardiothorac Vasc Anesth. 2002 Aug;16(4):441-6. (2002) Abstract

Fabling JM, Gan TJ, El-Moalem HE, Warner DS, Borel CO. A randomized, double-blind comparison of ondansetron versus placebo for prevention of nausea and vomiting after infratentorial craniotomy. J Neurosurg Anesthesiol. 2002 Apr;14(2):102-7. (2002) Abstract

Gan TJ, White PF, Scuderi PE, Watcha MF, Kovac A. FDA "black box" warning regarding use of droperidol for postoperative nausea and vomiting: is it justified? Anesthesiology. 2002 Jul;97(1):287. (2002) Abstract

Erb TO, Kanter RJ, Hall JM, Gan TJ, Kern FH, Schulman SR. Comparison of electrophysiologic effects of propofol and isoflurane-based anesthetics in children undergoing radiofrequency catheter ablation for supraventricular tachycardia. Anesthesiology. 2002 Jun;96(6):1386-94. (2002) Abstract

Murdoch JA, Gan TJ. Anesthesia for hysteroscopy. Anesthesiol Clin North America. 2001 Mar;19(1):125-40. (2001) Abstract

Gan TJ, Soppitt A, Maroof M, el-Moalem H, Robertson KM, Moretti E, Dwane P, Glass PS. Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology. 2002 Oct;97(4):820-6. (2002) Abstract

Gan TJ, Franiak R, Reeves J. Ondansetron orally disintegrating tablet versus placebo for the prevention of postdischarge nausea and vomiting after ambulatory surgery. Anesth Analg. 2002 May;94(5):1199-200, table of contents. (2002) Abstract

Alexander R, El-Moalem HE, Gan TJ. Comparison of the morphine-sparing effects of diclofenac sodium and ketorolac tromethamine after major orthopedic surgery. J Clin Anesth. 2002 May;14(3):187-92. (2002) Abstract

Moretti EW, Robertson KM, Tuttle-Newhall JE, Clavien PA, Gan TJ. Orthotopic liver transplant patients require less postoperative morphine than do patients undergoing hepatic resection. J Clin Anesth. 2002 Sep;14(6):416. (2002) Abstract

Gan TJ. Acute pain management: patients experience and meeting JCAHO guidelines. SAMBA 2002 Annual Meeting Lectures, presented at SAMBA 17th Annual Meeting in Orlando, FL, May 2-5, 2002.  Supplement to Anesth Analg pg. 11-14. (2002)

Gan TJ, Hopkins M. Sloan B, Lubarsky D. Main causes of delay in in-patient discharge from PACU in a major teaching hospital. Anesthesiology 2002; 97: A1136. (2002)

Gan TJ, Meyer T, PONV Consensus Panel: Christian A, Chung F, Davis P, Eubanks S, Kovac A, Philips B, Sessler D, Temo J, Tramer M, Watcha M. PONV management consensus guidelines. Anesthesiology 2002; 97: A1194. (2002)

Gan TJ, Meyer T, PONV Consensus Panel: Christian A, Chung F, Davis P, Eubanks S, Kovac A, Philips B, Sessler D, Temo J, Tramer M, Watcha M. A consensus panel identification of risk factors for PONV.  Anesthesiology 2002; 97:A19. (2002)

Viscusi E, Joshi G, Gan TJ, Chen C, Cheung R. In-hospital resource use to manage pain after single dose of IV parecoxib sodium, a novel parenteral COX-2 inhibitor, for pain associated with laparoscopic cholecystectomy. Anesthesiology 2002; 97: A28. (2002)

Moretti EW, Robertson KM, El-Moalem H, Gan TJ. Intraoperative colloid administration reduces postoperative nausea and vomiting and improves postoperative outcomes compared with crystalloid administration. Anesth Analg. 2003 Feb;96(2):611-7, table of contents. (2003) Abstract

Erb TO, Hall JM, Ing RJ, Kanter RJ, Kern FH, Schulman SR, Gan TJ. Postoperative nausea and vomiting in children and adolescents undergoing radiofrequency catheter ablation: a randomized comparison of propofol- and isoflurane-based anesthetics. Anesth Analg. 2002 Dec;95(6):1577-81, table of contents. (2002) Abstract