Tong-Joo Gan, MD

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

• MD, London Hospital Medical College (United Kingdom), 1987

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

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

Research Interests:
My current research interests include postoperative nausea and vomiting (PONV), acute postoperative pain, clinical pharmacology of anesthetic drugs and resuscitation fluids as well as database research in postoperative outcomes.

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 methods of delivery of these medications.

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

Improving 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 International 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 effect mortality and influence the length of hospital stay.  However, the quality of recovery, such as the avoidance of pain and absence of postoperative nausea and vomiting can be prevented.  In these days of cost containment in healthcare, managed care companies may not be interested in additional expenses that do not have an impact on the duration of hospital stay.  With new methodology, I am assessing patients willingness to pay to avoid these postoperative discomforts.

Representative Publications:
Ho KY, Jones L, Gan TJ. The effect of cultural background on the usage of complementary and alternative medicine for chronic pain management. Pain Physician. 2009 May-Jun;12(3):685-8. (2009) Abstract

Habib AS, Wahl K, Gu J, Gan TJ. Comparison of postoperative pain outcomes after vertical or Pfannenstiel incision for major gynecologic surgery * Curr Med Res Opin. 2009 May 13. (2009) Abstract

Habib AS, Polascik TJ, Weizer AZ, White WD, Moul JW, ElGasim MA, Gan TJ. Lidocaine patch for postoperative analgesia after radical retropubic prostatectomy. Anesth Analg. 2009 Jun;108(6):1950-3. (2009) Abstract

Gan TJ, Sinha AC, Kovac AL, Jones RK, Cohen SA, Battikha JP, Deutsch JS, Pergolizzi JV Jr, , Glass PS. A randomized, double-blind, multicenter trial comparing transdermal scopolamine plus ondansetron to ondansetron alone for the prevention of postoperative nausea and vomiting in the outpatient setting. Anesth Analg. 2009 May;108(5):1498-504. (2009) Abstract

Sun Y, Gan TJ. Acupuncture for the management of chronic headache: a systematic review. Anesth Analg. 2008 Dec;107(6):2038-47. (2008) Abstract

Sun Y, Gan TJ, Dubose JW, Habib AS. Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials. Br J Anaesth. 2008 Aug;101(2):151-60. (2008) Abstract

Habib AS, Gan TJ. The use of droperidol before and after the Food and Drug Administration black box warning: a survey of the members of the Society of Ambulatory Anesthesia. J Clin Anesth. 2008 Feb;20(1):35-9. (2008) Abstract

Habib AS, Gan TJ. Pro: The Food and Drug Administration Black box warning on droperidol is not justified. Anesth Analg. 2008 May;106(5):1414-7. (2008) Abstract

Pyati S, Gan TJ. Perioperative pain management. CNS Drugs. 2007;21(3):185-211. (2007) Abstract

Kranke P, Eberhart LH, Gan TJ, Roewer N, Tramèr MR. Algorithms for the prevention of postoperative nausea and vomiting: an efficacy and efficiency simulation. Eur J Anaesthesiol. 2007 Oct;24(10):856-67. (2007) Abstract

Kerger H, Turan A, Kredel M, Stuckert U, Alsip N, Gan TJ, Apfel CC. Patients' willingness to pay for anti-emetic treatment. Acta Anaesthesiol Scand. 2007 Jan;51(1):38-43. (2007) Abstract

Gan TJ. Mechanisms underlying postoperative nausea and vomiting and neurotransmitter receptor antagonist-based pharmacotherapy. CNS Drugs. 2007;21(10):813-33. (2007) Abstract

Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, Hooper VD, Kovac AL, Kranke P, Myles P, Philip BK, Samsa G, Sessler DI, Temo J, Tramèr MR, Vander Kolk C, Watcha M, . Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2007 Dec;105(6):1615-28, table of contents. (2007) Abstract

Gan TJ, Apfel CC, Kovac A, Philip BK, Singla N, Minkowitz H, Habib AS, Knighton J, Carides AD, Zhang H, Horgan KJ, Evans JK, Lawson FC, . A randomized, double-blind comparison of the NK1 antagonist, aprepitant, versus ondansetron for the prevention of postoperative nausea and vomiting. Anesth Analg. 2007 May;104(5):1082-9, tables of contents. (2007) Abstract

Diemunsch P, Apfel C, Gan TJ, Candiotti K, Philip BK, Chelly J, Carides AD, Evans JK, Ho TW, Reiss T. Preventing postoperative nausea and vomiting: post hoc analysis of pooled data from two randomized active-controlled trials of aprepitant. Curr Med Res Opin. 2007 Oct;23(10):2559-65. (2007) Abstract

Allen TK, Habib AS, Dear GL, White W, Lubarsky DA, Gan TJ. How much are patients willing to pay to avoid postoperative muscle pain associated with succinylcholine? J Clin Anesth. 2007 Dec;19(8):601-8. (2007) Abstract

Ho KY, Gan TJ. Pharmacology, pharmacogenetics, and clinical efficacy of 5-hydroxytryptamine type 3 receptor antagonists for postoperative nausea and vomiting. Curr Opin Anaesthesiol. 2006 Dec;19(6):606-11. (2006) Abstract

Ho KY, Gan TJ, Habib AS. Gabapentin and postoperative pain - a systematic review of randomized controlled trials. Pain. 2006 Jul 15. (2006) Abstract

Habib AS, Itchon-Ramos N, Phillips-Bute BG, Gan TJ, . Transcutaneous acupoint electrical stimulation with the ReliefBand for the prevention of nausea and vomiting during and after cesarean delivery under spinal anesthesia. Anesth Analg. 2006 Feb;102(2):581-4. (2006) Abstract

Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg. 2006 Jun;102(6):1884-98. (2006) Abstract

Grocott MP, Mythen MG, Gan TJ. Perioperative fluid management and clinical outcomes in adults. Anesth Analg. 2005 Apr;100(4):1093-106. (2005) Abstract

Gan TJ. Selective serotonin 5-HT3 receptor antagonists for postoperative nausea and vomiting: are they all the same? CNS Drugs. 2005;19(3):225-38. (2005) Abstract

Gan TJ, Coop A, Philip BK. A randomized, double-blind study of granisetron plus dexamethasone versus ondansetron plus dexamethasone to prevent postoperative nausea and vomiting in patients undergoing abdominal hysterectomy. Anesth Analg. 2005 Nov;101(5):1323-9. (2005) Abstract

D'Angelo R, Philip B, Gan TJ, Kovac A, Hantler C, Doblar D, Melson T, Minkowitz H, Dalby P, Coop A. A randomized, double-blind, close-ranging, pilot study of intravenous granisetron in the prevention of postoperative nausea and vomiting in patients abdominal hysterectomy. Eur J Anaesthesiol. 2005 Oct;22(10):774-9. (2005) Abstract

Joshi GP, Viscusi ER, Gan TJ, Minkowitz H, Cippolle M, Schuller R, Cheung RY, Fort JG. Effective treatment of laparoscopic cholecystectomy pain with intravenous followed by oral COX-2 specific inhibitor. Anesth Analg. 2004 Feb;98(2):336-42, table of contents. (2004) Abstract

Habib AS, Gan TJ. Evidence-based management of postoperative nausea and vomiting: a review. Can J Anaesth. 2004 Apr;51(4):326-41. (2004) Abstract

Habib AS, El-Moalem HE, Gan TJ. The efficacy of the 5-HT3 receptor antagonists combined with droperidol for PONV prophylaxis is similar to their combination with dexamethasone. A meta-analysis of randomized controlled trials. Can J Anaesth. 2004 Apr;51(4):311-9. (2004) Abstract

Gan TJ, Lubarsky DA, Flood EM, Thanh T, Mauskopf J, Mayne T, Chen C. Patient preferences for acute pain treatment. Br J Anaesth. 2004 May;92(5):681-8. (2004) Abstract

Gan TJ, Joshi GP, Viscusi E, Cheung RY, Dodge W, Fort JG, Chen C. Preoperative parenteral parecoxib and follow-up oral valdecoxib reduce length of stay and improve quality of patient recovery after laparoscopic cholecystectomy surgery. Anesth Analg. 2004 Jun;98(6):1665-73, table of contents. (2004) Abstract

Gan TJ, Jiao KR, Zenn M, Georgiade G. A randomized controlled comparison of electro-acupoint stimulation or ondansetron versus placebo for the prevention of postoperative nausea and vomiting. Anesth Analg. 2004 Oct;99(4):1070-5, table of contents. (2004) Abstract

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

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)

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

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

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)

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)

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

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

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

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)

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

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

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

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

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

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

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)

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

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)

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

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

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

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)

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

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)

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

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

Gan TJ. Postoperative nausea and vomiting--can it be eliminated? JAMA. 2002 Mar 13;287(10):1233-6. (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, Wright D, Somma J, McClurkin I.  Pentalyte, a novel middle molecular weight starch in balanced electrolyte solution. Anesthesiology 2002; 97:A440. (2002)

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

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, 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)

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)

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

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

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

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

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

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

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

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

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

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, 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

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

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)