Research Topics
| Christian C ApfelSummaryAffiliation: University of California Country: USA Publications
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Publications
Supplemental intravenous crystalloids for the prevention of postoperative nausea and vomiting: quantitative reviewC C Apfel
Perioperative Clinical Research Core, Department of Anaesthesia and Perioperative Care, University of California San Francisco, UCSF Medical Center at Mt Zion, 1600 Divisadero, C 447, San Francisco, CA 94115, USA
Br J Anaesth 108:893-902. 2012..However, a number of PONV outcomes failed to reach statistical significance, perhaps due to the lack of power. Thus, studies sufficiently powered for the less frequent outcomes (e.g. POV) are required...
[Postoperative nausea and vomiting]C C Apfel
Department of Anesthesiology and Perioperative Medicine, Outcomes Research Institute, University of Louisville, KY 40202, USA
Anaesthesist 53:377-89; quiz 390-1. 2004..For the treatment of PONV an antiemetic should be chosen which has not been used prophylactically. The necessary doses are usually a quarter of those needed for prophylaxis...- PONV: a problem of inhalational anaesthesia?Christian C Apfel
Department of Anesthesiology and Perioperative Medicine, and Outcomes Research Institute, University of Louisville, 501 E Broadway, Suite 210, Louisville, KY 40202, USA
Best Pract Res Clin Anaesthesiol 19:485-500. 2005..However, since volatile anaesthetics are probably not the most important risk factors, it might be even better--if appropriate--to avoid general anaesthesia by using a regional, opioid-free anaesthesia if PONV is a serious problem... - [Nausea and vomiting in the postoperative phase. Expert- and evidence-based recommendations for prophylaxis and therapy]C C Apfel
Perioperative Clinical Research Core, Department of Anesthesia and Perioperative Care, University of California, San Francisco, UCSF Medical Center at Mt Zion, 1600 Divisadero, C 355, San Francisco, California 94115 1605, USA
Anaesthesist 56:1170-80. 2007..These algorithms should provide evidence-based guidelines allowing the development of SOPs/policies which take local circumstances into account... - [A factorial trial of six interventions for the prevention of postoperative nausea and vomiting]C C Apfel
Klinik und Poliklinik für Anaesthesiologie, Julius Maximilians Universitat, Wurzburg
Anaesthesist 54:201-9. 2005..Although many trials have been conducted, the relative benefits of prophylactic antiemetic interventions given alone or in combination remain unknown... 
A factorial trial of six interventions for the prevention of postoperative nausea and vomitingChristian C Apfel
Julius Maximilians Universitat, Wurzburg, Germany
N Engl J Med 350:2441-51. 2004..Although many trials have been conducted, the relative benefits of prophylactic antiemetic interventions given alone or in combination remain unknown...- Restoration of disk height through non-surgical spinal decompression is associated with decreased discogenic low back pain: a retrospective cohort studyChristian C Apfel
Perioperative Clinical Research Core, Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA
BMC Musculoskelet Disord 11:155. 2010.... - The role of neurokinin-1 receptor antagonists for the management of postoperative nausea and vomitingChristian C Apfel
Perioperative Clinical Research Core, Department of Anesthesiology and Perioperative Care, University of California, San Francisco, California, USA
Curr Opin Anaesthesiol 21:427-32. 2008..To review the characteristics of neurokinin-1 receptor antagonists and their potential role in the management of postoperative nausea and vomiting... - An international multicenter protocol to assess the single and combined benefits of antiemetic interventions in a controlled clinical trial of a 2x2x2x2x2x2 factorial design (IMPACT)Christian C Apfel
Department of Anesthesiology, University of Wuerzburg, Wuerzburg, Germany
Control Clin Trials 24:736-51. 2003..To the best of our knowledge this is the first randomized controlled trial of a six-way factorial design that may serve as an example for numerous other medical specialties... - The effect of postoperative fasting on vomiting in children and their assessment of painOliver C Radke
Perioperative Clinical Research Core, Department of Anesthesia and Perioperative Care, University of California at San Francisco, UCSF Medical Center at Mount Zion, San Francisco, CA 94115, USA
Paediatr Anaesth 19:494-9. 2009..Mandatory postoperative food intake has been shown to increase nausea and vomiting, and so postoperative fasting has become common practice even if patients request food or drink... - Who is at risk for postdischarge nausea and vomiting after ambulatory surgery?Christian C Apfel
Epidemiology and Biostatistics, Mt Zion Medical Center, San Francisco General Hospital, Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California 94115, USA
Anesthesiology 117:475-86. 2012..Fortunately, risk scores have been developed to better manage this outcome in hospitalized patients, but there is currently no risk score for postdischarge nausea and vomiting (PDNV) in ambulatory surgical patients... - Neurokinin-1 and novel serotonin antagonists for postoperative and postdischarge nausea and vomitingElizabeth George
Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California 94115, USA
Curr Opin Anaesthesiol 23:714-21. 2010..Finally, we will discuss strategies for prophylaxis and treatment of PONV and PDNV that address the unique concerns in ambulatory surgery patients... - Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomitingTong J Gan
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA
Anesth Analg 105:1615-28, table of contents. 2007.... - A randomized, double-blind comparison of the NK1 antagonist, aprepitant, versus ondansetron for the prevention of postoperative nausea and vomitingTong J Gan
Department of Anesthesiology, Duke University Medical Centre, Durham, North Carolina 27710, USA
Anesth Analg 104:1082-9, tables of contents. 2007..This is the first study evaluating the efficacy and tolerability of the neurokinin-1 receptor antagonist, aprepitant, for the prevention of postoperative nausea and vomiting... - Transdermal scopolamine for the prevention of postoperative nausea and vomiting: a systematic review and meta-analysisChristian C Apfel
Perioperative Clinical Research Core, Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, California 94115, USA or
Clin Ther 32:1987-2002. 2010.... - Intravenous buspirone for the prevention of postoperative nausea and vomitingPeter Kranke
Department of Anaesthesiology and Critical Care, University Hospitals of Würzburg, 97080, Wurzburg, Germany
Eur J Clin Pharmacol 68:1465-72. 2012..Buspirone, a partial 5HT(1A) agonist and D₂ and D₃ antagonist, has shown promising antiemetic efficacy when given parenterally in animal models, but its efficacy for the prevention of postoperative nausea and vomiting (PONV) is unknown... - Pharmacologic management of postoperative nausea and vomitingKatherine E Fero
University of California, UCSF Medical Center, Department of Anesthesia and Perioperative Care, Mount Zion Campus, 1600 Divisadero, C 447, San Francisco, CA 94115, USA
Expert Opin Pharmacother 12:2283-96. 2011..If a patient has 0, 1, 2, 3 or 4 of the four risk factors, we apply a similar number of antiemetic strategies... - Nausea and vomiting after office-based anesthesiaKerstin Kolodzie
Perioperative Clinical Research Core, Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California 94115, USA
Curr Opin Anaesthesiol 22:532-8. 2009..This article reviews the incidences and risk factors for PDNV as well as medications and concepts for prophylaxis and treatment... - Prevention of pain on injection of propofol: systematic review and meta-analysisLeena Jalota
Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, 94115 CA, USA
BMJ 342:d1110. 2011..To systematically determine the most efficacious approach for preventing pain on injection of propofol... - Does supplemental oxygen reduce postoperative nausea and vomiting? A meta-analysis of randomized controlled trialsMukadder Orhan-Sungur
Outcomes Research Institute, Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, Kentucky, USA
Anesth Analg 106:1733-8. 2008..Studies on the ability of supplemental oxygen to decrease the incidence of postoperative nausea and vomiting (PONV) are inconsistent, with initial studies suggesting benefit while subsequent trials demonstrate no decrease in PONV... - Droperidol has comparable clinical efficacy against both nausea and vomitingC C Apfel
Clinical Research Core, Department of Anesthesia and Perioperative Care, UCSF Mount Zion Hospital, University of California San Francisco, 1600 Divisadero Street, C 447, San Francisco, CA 94115, USA
Br J Anaesth 103:359-63. 2009..This may be relevant for clinical decisions, especially for designing multiple-drug antiemetic regimens... - Does neostigmine administration produce a clinically important increase in postoperative nausea and vomiting?Ching Rong Cheng
Outcomes Research Institute and Department of Anesthesiology and Preoperative Medicine, University of Louisville, KY, 40202, USA
Anesth Analg 101:1349-55. 2005..Contrasting a previous analysis, we conclude that there is insufficient evidence to conclude that neostigmine increases the risk of postoperative nausea and vomiting... - Intravenous acetaminophen reduces postoperative nausea and vomiting: A systematic review and meta-analysisChristian C Apfel
Department of Anesthesia and Perioperative Care, UCSF Medical Center at Mt Zion, San Francisco, CA, USA Department of Epidemiology and Biostatistics, UCSF Medical Center at Mt Zion, San Francisco, CA, USA Electronic address
Pain 154:677-89. 2013..66, 0.47-0.93), but not with reduction in postoperative opioids (odds ratio 0.89, 0.64-1.22). Prophylactically administered i.v. acetaminophen reduced PONV, mainly mediated through superior pain control... - Consensus guidelines for managing postoperative nausea and vomitingTong J Gan
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA
Anesth Analg 97:62-71, table of contents. 2003..IMPLICATIONS: We present evidence-based guidelines developed by an international panel of experts for the management of postoperative nausea and vomiting... - Risk assessment of postoperative nausea and vomitingChristian C Apfel
Department of Anesthesiology, Outcomes Research Institute, 501 E Broadway, Suite 201, Louisville, KY 40202, USA
Int Anesthesiol Clin 41:13-32. 2003 - The influence of a dominating centre on a quantitative systematic review of granisetron for preventing postoperative nausea and vomitingP Kranke
Department of Anaesthesiology, University of Wuerzburg, Germany
Acta Anaesthesiol Scand 45:659-70. 2001.... - An admission bioclinical score to predict 1-year outcomes in patients undergoing aneurysm coilingVincent Degos
Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA 94110, USA
Stroke 43:1253-9. 2012..Our goal was to develop, compare, and validate a predictive score for 1-year outcomes in patients with coiled subarachnoid hemorrhage... - A simple clinical maneuver to reduce laparoscopy-induced shoulder pain: a randomized controlled trialPaul Phelps
Department of Anesthesia, Southwest Healthcare System, Murrieta, California, USA
Obstet Gynecol 111:1155-60. 2008..To estimate the efficacy of a simple clinical maneuver that facilitates removal of residual abdominal carbon dioxide (CO2) after laparoscopic surgery to reduce shoulder pain... - How to study postoperative nausea and vomitingC C Apfel
Department of Anesthesiology, Julius Maximilians University, Wuerzburg, Germany
Acta Anaesthesiol Scand 46:921-8. 2002..Lastly, interpretation of results should take into account the study hypothesis, sources of potential bias or imprecision, and the difficulties associated with multiplicity of analysis and outcomes... - A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centersC C Apfel
Department of Anesthesiology, University of Wuerzburg, Germany
Anesthesiology 91:693-700. 1999..This study investigated (1) whether risk scores are valid across centers and (2) whether risk scores based on logistic regression coefficients can be simplified without loss of discriminating power... - Comparison of predictive models for postoperative nausea and vomitingC C Apfel
Department of Anaesthesiology, Julius Maximilians University, , Germany
Br J Anaesth 88:234-40. 2002..Therefore, simplified risk scores can be recommended for antiemetic strategies in clinical practice as well as for group comparisons in randomized controlled antiemetic trials... - Prevention of postdural puncture headache after accidental dural puncture: a quantitative systematic reviewC C Apfel
Perioperative Clinical Research Core, Department of Anesthesia and Perioperative Care, University of California at San Francisco, 1600 Divisadero St, San Francisco, CA, USA
Br J Anaesth 105:255-63. 2010..Thus, a large multicentre RCT is needed to determine the best preventative practices... - Comparison of surgical site and patient's history with a simplified risk score for the prediction of postoperative nausea and vomitingC C Apfel
Department of Anaesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY 40202, USA
Anaesthesia 59:1078-82. 2004..56-0.61) while for risk score it was 0.68 (95% CI 0.66-0.71; P < 0.001). Prediction using surgical site or patient's history alone was poor while the simplified risk score provided clinically useful sensitivity and specificity... - Effect of increased body mass index and anaesthetic duration on recovery of protective airway reflexes after sevoflurane vs desfluraneR E McKay
Department of Anaesthesia and Perioperative Care, C 450, University of California San Francisco, San Francisco, CA 94143 0648, USA
Br J Anaesth 104:175-82. 2010..Increased BMI may increase the body's capacity to store potent inhaled anaesthetics, more so with more soluble agents. Accordingly, we asked whether increased BMI and longer anaesthesia prolonged airway reflex recovery... - The influence of the weather and the phase of the moon on post-operative nausea and vomitingM Kredel
Department of Anaesthesiology, Julius-Maximilians-University of Wuerzburg, Wuerzburg, Germany
Acta Anaesthesiol Scand 50:488-94. 2006..CONCLUSION: These data suggest that neither the weather nor the phases of the moon have any clinically relevant effect on the incidence of PONV after general anaesthesia... - [Pathophysiology, risk factors and assessment for nausea and vomiting in the postoperative phase]C C Apfel
Department of Anesthesiology, University of Louisville, Louisville, KY 40202, USA. edu
Anasthesiol Intensivmed Notfallmed Schmerzther 40:497-503. 2005 - Prospective application of a simplified risk score to prevent postoperative nausea and vomitingDirk Rüsch
Klinik fur Anasthesiologie und Operative Intensivmedizin, Universitatsklinikum Schleswig Holstein, Campus Kiel, Germany
Can J Anaesth 52:478-84. 2005..To compare the risk-adapted approach with ondansetron against ondansetron plus dexamethasone to prevent postoperative nausea and vomiting (PONV) in a randomized clinical trial... - A risk score-dependent antiemetic approach effectively reduces postoperative nausea and vomiting--a continuous quality improvement initiativeSébastien Pierre
Department of Anesthesiology, Institut Claudius Regaud, Toulouse, France
Can J Anaesth 51:320-5. 2004..Consequently, we investigated whether a risk score-dependent antiemetic strategy could effectively reduce the incidence of PONV in our department... - The additive interactions between ondansetron and droperidol for preventing postoperative nausea and vomitingMatthew T V Chan
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region
Anesth Analg 103:1155-62. 2006..Both drugs acted independently of each other through their specific mechanisms of action. The incidence of QTc prolongation did not increase with the drug combination... - A risk adapted approach reduces the overall institutional incidence of postoperative nausea and vomitingAndreas Biedler
Klinik für Anaesthesiologie und Intensivmedizin, Universitatskliniken des Saarlandes, Homburg Saar, Germany
Can J Anaesth 51:13-9. 2004..The objective of this investigation was to assess the feasibility and efficacy of a dichotomized risk score adapted management of PONV based on ondansetron prophylaxis and treatment with respect to the overall institutional rate of PONV... - Identification of risk factors for postoperative nausea and vomiting in the perianesthesia adult patientMarguerite J Murphy
School of Nursing, Medical College of Georgia, Augusta, GA, USA
J Perianesth Nurs 21:377-84. 2006..The identification of risk factors associated with PONV and the factors that are independent predictors of PONV preoperatively can facilitate the effective prophylactic treatment and management of PONV in adult surgical patients... - Comparative pharmacodynamic modeling using bispectral and narcotrend-index with and without a pharmacodynamic plateau during sevoflurane anesthesiaSascha Kreuer
Department of Anesthesiology and Intensive Care Medicine, University of Saarland, 66421 Homburg Saar, Germany
Anesth Analg 106:1171-81, table of contents. 2008..0) were used as an electroencephalographic measure of sevoflurane drug effect. In addition, we tried to analyze the origin of the plateau... - Influence of intraoperative conversion from off-pump to on-pump coronary artery bypass grafting on costs and quality of life: a cost-effectiveness analysisToshiya Shiga
Second Department of Anesthesiology, Toho University School of Medicine, Meguro ku, Tokyo, Japan
J Cardiothorac Vasc Anesth 21:793-9. 2007..The objective of this study was to determine whether intraoperative conversion affects costs and quality of life... - Transdermal nicotine patch failed to improve postoperative pain managementAlparslan Turan
Department of Anesthesiology, Trakya University, Turkey
Anesth Analg 107:1011-7. 2008....