Dr. Mahesh Nagappa
Associate Professor
Biography
Dr. Nagappa received his MD in Anesthesia from JIPMER, University of Puducherry in India in 2008. He joins us from Toronto Western Hospital, University of Toronto, following a fellowship in Perioperative Medicine and Ambulatory Anesthesia. Nagappa has several publications in Journals such as the Anesthesia Analgesia, PLOS, Chest Journal, Current opinion in Anesthesiology and Canadian Journal of Anesthesia.
At the 2014 Annual IARS Meeting in Montreal, Canada, Dr. Nagappa received the “best of the category award” and nominated for the “best of the meeting award”.
His current research interests include Ambulatory Anesthesia, perioperative patient management, screening, treatment and perioperative complications associated with obesity/OSA, also systematic review, meta-analysis and meta-regression analysis. Dr. Nagappa is an avid presenter with many poster and power point presentations at annual anesthesia meetings such as: IARS, ASA, SASM, ISPCOP, CSS and CAS. Many of his meeting presentations have been published in “Anesthesiology News” circulated to more than 45,000 anesthesiologists in North America.
Publications
Yan E, Veitch M, Saripella A, Alhamdah Y, Butris N, Tang-Wai DF, Tartaglia MC, Nagappa M, Englesakis M, He D, Chung F. Association between postoperative delirium and adverse outcomes in older surgical patients: A systematic review and meta-analysis. J Clin Anesth. 2023 Nov;90:111221. doi: 10.1016/j.jclinane.2023.111221. Epub 2023 Jul 27. PMID: 37515876.
Dominguez JE, Cantrell S, Habib AS, Izci-Balserak B, Lockhart E, Louis JM, Miskovic A, Nadler JW, Nagappa M, O'Brien LM, Won C, Bourjeily G. Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology Consensus Guideline on the Screening, Diagnosis, and Treatment of Obstructive Sleep Apnea in Pregnancy. Obstet Gynecol. 2023 Aug 1;142(2):403-423. doi: 10.1097/AOG.0000000000005261. Epub 2023 Jul 5. PMID: 37411038; PMCID: PMC10351908.
Ruan B, Nagappa M, Rashid-Kolvear M, Zhang K, Waseem R, Englesakis M, Chung F. The effectiveness of supplemental oxygen and high-flow nasal cannula therapy in patients with obstructive sleep apnea in different clinical settings: A systematic review and meta-analysis. J Clin Anesth. 2023 Sep;88:111144. doi: 10.1016/j.jclinane.2023.111144. Epub 2023 May 10. PMID: 37172556.
Butris N, Tang E, Pivetta B, He D, Saripella A, Yan E, Englesakis M, Boulos MI, Nagappa M, Chung F. The prevalence and risk factors of sleep disturbances in surgical patients: A systematic review and meta-analysis. Sleep Med Rev. 2023 Jun;69:101786. doi: 10.1016/j.smrv.2023.101786. Epub 2023 Apr 19. PMID: 37121133.
National Institute for Health and Care Research Global Health Research Unit on Global Surgery. Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries. Br J Surg. 2023 Jun 12;110(7):804-817. doi: 10.1093/bjs/znad092. Erratum in: Br J Surg. 2023 Nov 9;110(12):1907. PMID: 37079880; PMCID: PMC10364528.
Au E, Thangathurai G, Saripella A, Yan E, Englesakis M, Nagappa M, Chung F. Postoperative Outcomes in Elderly Patients Undergoing Cardiac Surgery With Preoperative Cognitive Impairment: A Systematic Review and Meta-Analysis. Anesth Analg. 2023 Jun 1;136(6):1016-1028. doi: 10.1213/ANE.0000000000006346. Epub 2023 Jan 11. PMID: 36728298.
Hwang M, Nagappa M, Guluzade N, Saripella A, Englesakis M, Chung F. Validation of the STOP-Bang questionnaire as a preoperative screening tool for obstructive sleep apnea: a systematic review and meta-analysis. BMC Anesthesiol. 2022 Nov 30;22(1):366. doi: 10.1186/s12871-022-01912-1. PMID: 36451106; PMCID: PMC9710034.
Berezin L, Nagappa M, Poorzargar K, Saripella A, Ariaratnam J, Butris N, Englesakis M, Chung F. The effectiveness of positive airway pressure therapy in reducing postoperative adverse outcomes in surgical patients with obstructive sleep apnea: A systematic review and meta-analysis. J Clin Anesth. 2023 Feb;84:110993. doi: 10.1016/j.jclinane.2022.110993. Epub 2022 Nov 5. PMID: 36347195.
NIHR Global Health Unit on Global Surgery; COVIDSurg Collaborative. Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries. Lancet. 2022 Nov 5;400(10363):1607-1617. doi: 10.1016/S0140-6736(22)01846-3. Epub 2022 Oct 31. PMID: 36328042; PMCID: PMC9621702.
Chen L, Au E, Saripella A, Kapoor P, Yan E, Wong J, Tang-Wai DF, Gold D, Riazi S, Suen C, He D, Englesakis M, Nagappa M, Chung F. Postoperative outcomes in older surgical patients with preoperative cognitive impairment: A systematic review and meta-analysis. J Clin Anesth. 2022 Sep;80:110883. doi: 10.1016/j.jclinane.2022.110883. Epub 2022 May 24. PMID: 35623265.
Nagappa M, Querney J, Martin J, John-Baptiste A, Subramani Y, Lanting B, Schlachta C, Von Koughnett JA, Speechley K, Correa J, Yunus Chohan MB, Rrafshi N, Batohi M, Fayad A, Yang H. Perioperative Satisfaction and Health Economic Questionnaires in Patients Undergoing an Elective Hip and Knee Arthroplasty: A Prospective Observational Cohort Study. Anesth Essays Res. 2021 Oct-Dec;15(4):413-438. doi: 10.4103/aer.aer_5_22. Epub 2022 Mar 30. PMID: 35422546; PMCID: PMC9004266.
Poorzargar K, Pham C, Ariaratnam J, Lee K, Parotto M, Englesakis M, Chung F, Nagappa M. Accuracy of pulse oximeters in measuring oxygen saturation in patients with poor peripheral perfusion: a systematic review. J Clin Monit Comput. 2022 Aug;36(4):961-973. doi: 10.1007/s10877-021-00797-8. Epub 2022 Feb 4. PMID: 35119597.
Patel D, Tsang J, Saripella A, Nagappa M, Islam S, Englesakis M, Chung F. Validation of the STOP questionnaire as a screening tool for OSA among different populations: a systematic review and meta-regression analysis. J Clin Sleep Med. 2022 May 1;18(5):1441-1453. doi: 10.5664/jcsm.9820. PMID: 34910625; PMCID: PMC9059595.
Kapoor P, Chen L, Saripella A, Waseem R, Nagappa M, Wong J, Riazi S, Gold D, Tang-Wai DF, Suen C, Englesakis M, Norman R, Sinha SK, Chung F. Prevalence of preoperative cognitive impairment in older surgical patients.: A systematic review and meta-analysis. J Clin Anesth. 2022 Feb;76:110574. doi: 10.1016/j.jclinane.2021.110574. Epub 2021 Nov 5. PMID: 34749047.
Subramani Y, Querney J, He S, Nagappa M, Yang H, Fayad A. Efficacy and Safety of Sugammadex versus Neostigmine in Reversing Neuromuscular Blockade in Morbidly Obese Adult Patients: A Systematic Review and Meta-Analysis. Anesth Essays Res. 2021 Jan-Mar;15(1):111-118. doi: 10.4103/aer.aer_79_21. Epub 2021 Aug 30. PMID: 34667357; PMCID: PMC8462431.
McGillion MH, Parlow J, Borges FK, Marcucci M, Jacka M, Adili A, Lalu MM, Ouellette C, Bird M, Ofori S, Roshanov PS, Patel A, Yang H, O'Leary S, Tandon V, Hamilton GM, Mrkobrada M, Conen D, Harvey V, Lounsbury J, Mian R, Bangdiwala SI, Arellano R, Scott T, Guyatt GH, Gao P, Graham M, Nenshi R, Forster AJ, Nagappa M, Levesque K, Marosi K, Chaudhry S, Haider S, Deuchar L, LeBlanc B, McCartney CJL, Schemitsch EH, Vincent J, Pettit SM, DuMerton D, Paulin AD, Simunovic M, Williams DC, Halman S, Harlock J, Meyer RM, Taylor DA, Shanthanna H, Schlachta CM, Parry N, Pichora DR, Yousuf H, Peter E, Lamy A, Petch J, Moloo H, Sehmbi H, Waggott M, Shelley J, Belley-Cote EP, Devereaux PJ; PVC-RAM-1 Investigators. Post-discharge after surgery Virtual Care with Remote Automated Monitoring-1 (PVC-RAM-1) technology versus standard care: randomised controlled trial. BMJ. 2021 Sep 30;374:n2209. doi: 10.1136/bmj.n2209. PMID: 34593374; PMCID: PMC8477638.
COVIDSurg Collaborative; GlobalSurg Collaborative. SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study. Anaesthesia. 2022 Jan;77(1):28-39. doi: 10.1111/anae.15563. Epub 2021 Aug 24. PMID: 34428858; PMCID: PMC8652887.
COVIDSurg Collaborative; GlobalSurg Collaborative. Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study. Anaesthesia. 2021 Nov;76(11):1454-1464. doi: 10.1111/anae.15560. Epub 2021 Aug 9. PMID: 34371522.
Pham C, Poorzargar K, Nagappa M, Saripella A, Parotto M, Englesakis M, Lee K, Chung F. Effectiveness of consumer-grade contactless vital signs monitors: a systematic review and meta-analysis. J Clin Monit Comput. 2022 Feb;36(1):41-54. doi: 10.1007/s10877-021-00734-9. Epub 2021 Jul 9. PMID: 34240262; PMCID: PMC8266631.
McCarthy K, Saripella A, Selvanathan J, Nagappa M, Englesakis M, Wang D, Peng P, Chung F. Positive airway pressure therapy for chronic pain in patients with obstructive sleep apnea-a systematic review. Sleep Breath. 2022 Mar;26(1):47-55. doi: 10.1007/s11325-021-02363-7. Epub 2021 May 21. PMID: 34021465.
Subramani Y, El Tohamy O, Jalali D, Nagappa M, Yang H, Fayad A. Incidence, Risk Factors, and Outcomes of Perioperative Atrial Fibrillation following Noncardiothoracic Surgery: A Systematic Review and Meta-Regression Analysis of Observational Studies. Anesthesiol Res Pract. 2021 Apr 28;2021:5527199. doi: 10.1155/2021/5527199. PMID: 34007270; PMCID: PMC8099514.
Saripella A, Wasef S, Nagappa M, Riazi S, Englesakis M, Wong J, Chung F. Effects of comprehensive geriatric care models on postoperative outcomes in geriatric surgical patients: a systematic review and meta-analysis. BMC Anesthesiol. 2021 Apr 22;21(1):127. doi: 10.1186/s12871-021-01337-2. PMID: 33888071; PMCID: PMC8061210.
Seet E, Nagappa M, Wong DT. Airway Management in Surgical Patients With Obstructive Sleep Apnea. Anesth Analg. 2021 May 1;132(5):1321-1327. doi: 10.1213/ANE.0000000000005298. PMID: 33857974.
Berezin L, Nagappa M, Wong J, Clivatti J, Singh M, Auckley D, Charchaflieh JG, Jonsson Fagerlund M, Gali B, Joshi GP, Overdyk FJ, Margarson M, Mokhlesi B, Moon T, Ramachandran SK, Ryan CM, Schumann R, Weingarten TN, Won CHJ, Chung F. Identification of Sleep Medicine and Anesthesia Core Topics for Anesthesia Residency: A Modified Delphi Technique Survey. Anesth Analg. 2021 May 1;132(5):1223-1230. doi: 10.1213/ANE.0000000000005446. PMID: 33857964.
Sun Y, Laksono I, Selvanathan J, Saripella A, Nagappa M, Pham C, Englesakis M, Peng P, Morin CM, Chung F. Prevalence of sleep disturbances in patients with chronic non-cancer pain: A systematic review and meta-analysis. Sleep Med Rev. 2021 Jun;57:101467. doi: 10.1016/j.smrv.2021.101467. Epub 2021 Mar 11. PMID: 33827029.
COVIDSurg Collaborative, GlobalSurg Collaborative. SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study. Br J Surg. 2021 Sep 27;108(9):1056-1063. doi: 10.1093/bjs/znab101. PMID: 33761533; PMCID: PMC7995808.
COVIDSurg Collaborative; GlobalSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021 Jun;76(6):748-758. doi: 10.1111/anae.15458. Epub 2021 Mar 9. PMID: 33690889; PMCID: PMC8206995.
Pivetta B, Chen L, Nagappa M, Saripella A, Waseem R, Englesakis M, Chung F. Use and Performance of the STOP-Bang Questionnaire for Obstructive Sleep Apnea Screening Across Geographic Regions: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2021 Mar 1;4(3):e211009. doi: 10.1001/jamanetworkopen.2021.1009. PMID: 33683333; PMCID: PMC7941199.
Hwang M, Zhang K, Nagappa M, Saripella A, Englesakis M, Chung F. Validation of the STOP-Bang questionnaire as a screening tool for obstructive sleep apnoea in patients with cardiovascular risk factors: a systematic review and meta-analysis. BMJ Open Respir Res. 2021 Mar;8(1):e000848. doi: 10.1136/bmjresp-2020-000848. PMID: 33664122; PMCID: PMC7934717.
McGillion MH, Parlow J, Borges FK, Marcucci M, Jacka M, Adili A, Lalu MM, Yang H, Patel A, O'Leary S, Tandon V, Hamilton GM, Mrkobrada M, Ouellette C, Bird M, Ofori S, Conen D, Roshanov PS, Harvey V, Guyatt GH, Le Manach Y, Bangdiwala SI, Arellano R, Scott T, Lounsbury J, Taylor DA, Nenshi R, Forster AJ, Nagappa M, Lamy A, Peter E, Levesque K, Marosi K, Chaudhry S, Haider S, Deuchar L, LeBlanc B, McCartney CJL, Schemitsch EH, Vincent J, Pettit SM, Paul J, DuMerton D, Paulin AD, Simunovic M, Williams DC, Halman S, Schlachta CM, Shelley J, Harlock J, Meyer RM, Graham M, Shanthanna H, Parry N, Pichora DR, Yousef H, Moloo H, Sehmbi H, Waggott M, Belley-Cote EP, Whitlock R, Devereaux PJ; PVC-RAM Investigators. Post Discharge after Surgery Virtual Care with Remote Automated Monitoring Technology (PVC-RAM): protocol for a randomized controlled trial. CMAJ Open. 2021 Mar 2;9(1):E142-E148. doi: 10.9778/cmajo.20200176. Erratum in: CMAJ Open. 2021 Jun 18;9(2):E680. PMID: 33653769; PMCID: PMC8034369.
Selvanathan J, Pham C, Nagappa M, Peng PWH, Englesakis M, Espie CA, Morin CM, Chung F. Cognitive behavioral therapy for insomnia in patients with chronic pain - A systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev. 2021 Dec;60:101460. doi: 10.1016/j.smrv.2021.101460. Epub 2021 Feb 2. PMID: 33610967.
Chen L, Pivetta B, Nagappa M, Saripella A, Islam S, Englesakis M, Chung F. Validation of the STOP-Bang questionnaire for screening of obstructive sleep apnea in the general population and commercial drivers: a systematic review and meta-analysis. Sleep Breath. 2021 Dec;25(4):1741-1751. doi: 10.1007/s11325-021-02299-y. Epub 2021 Jan 28. PMID: 33507478; PMCID: PMC8590671.
Nagappa M, Wong DT. Is high-flow safer than low-flow nasal oxygenation for procedural sedation? Can J Anaesth. 2021 Apr;68(4):439-444. English. doi: 10.1007/s12630-020-01884-1. Epub 2021 Jan 12. PMID: 33432498.
Subramani Y, Nagappa M, Kumar K, Mortuza R, Fochesato LA, Chohan MBY, Martin J, Armstrong K, Singh SI. Medications for the prevention of pruritus in women undergoing cesarean delivery with Intrathecal morphine: A systematic review and bayesian network meta-analysis of randomized controlled trials. J Clin Anesth. 2021 Feb;68:110102. doi: 10.1016/j.jclinane.2020.110102. Epub 2020 Oct 28. PMID: 33129065.
Subramani Y, Nagappa M, Kumar K, Fochesato LA, Chohan MBY, Zhu YF, Armstrong K, Singh SI. Effect of intrathecal lipophilic opioids on the incidence of shivering in women undergoing cesarean delivery after spinal anesthesia: a systematic review and bayesian network meta- analysis of randomized controlled trials. BMC Anesthesiol. 2020 Aug 26;20(1):214. doi: 10.1186/s12871-020-01116-5. PMID: 32847522; PMCID: PMC7448354.
Mubashir T, Nagappa M, Esfahanian N, Botros J, Arif AA, Suen C, Wong J, Ryan CM, Chung F. Prevalence of sleep-disordered breathing in opioid users with chronic pain: a systematic review and meta-analysis. J Clin Sleep Med. 2020 Jun 15;16(6):961-969. doi: 10.5664/jcsm.8392. PMID: 32105208; PMCID: PMC7849655.
Nagappa M, Subramani Y, Chung F. Best perioperative practice in management of ambulatory patients with obstructive sleep apnea. Curr Opin Anaesthesiol. 2018 Dec;31(6):700-706. doi: 10.1097/ACO.0000000000000661.
Gupta K, Nagappa M, Prasad A, Abrahamyan L, Wong J, Weingarten TN, Chung F. Risk factors for opioid-induced respiratory depression in surgical patients: a systematic review and meta-analyses. BMJ Open. 2018 Dec 14;8(12):e024086. doi: 10.1136/bmjopen-2018-024086.
Nagappa M, Wong DT, Cozowicz C, Ramachandran SK, Memtsoudis SG, Chung F. Is obstructive sleep apnea associated with difficult airway? Evidence from a systematic review and meta-analysis of prospective and retrospective cohort studies. PLoS One. 2018 Oct 4;13(10):e0204904. doi: 10.1371/journal.pone.0204904
Gupta K, Prasad A, Nagappa M, Wong J, Abrahamyan L, Chung FF. Risk factors for opioid-induced respiratory depression and failure to rescue: a review. Curr Opin Anaesthesiol. 2018 Feb;31(1):110-119. doi: 10.1097/ACO.0000000000000541.
Memtsoudis SG, Cozowicz C, Nagappa M, Wong J, Joshi GP, Wong DT, Doufas AG, Yilmaz M, Stein MH, Krajewski ML, Singh M, Pichler L, Ramachandran SK, Chung F. Society of Anesthesia and Sleep Medicine Guideline on Intraoperative Management of Adult Patients With Obstructive Sleep Apnea. Anesth Analg. 2018 Jun 25. doi: 10.1213/ANE.0000000000003434. [Epub ahead of print]
Cozowicz C, Chung F, Doufas AG, Nagappa M, Memtsoudis SG. Opioids for Acute Pain Management in Patients With Obstructive Sleep Apnea: A Systematic Review. Anesth Analg. 2018 Jun 28. doi: 10.1213/ANE.0000000000003549. [Epub ahead of print]
Nagappa M, Weingarten TN, Montandon G, Sprung J, Chung F. Opioids, respiratory depression, and sleep-disordered breathing. Best Pract Res Clin Anaesthesiol. 2017 Dec;31(4):469-485. doi: 10.1016/j.bpa.2017.05.004. Epub 2017 May 22.
Lam T, Nagappa M, Wong J, Singh M, Wong D, Chung F. Continuous Pulse Oximetry and Capnography Monitoring for Postoperative Respiratory Depression and Adverse Events: A Systematic Review and Meta-analysis. Anesth Analg. 2017 Dec;125(6):2019-2029.
Nagappa M, Ho G, Patra J, Wong J, Singh M, Kaw R, Cheng D, Chung F. Postoperative Outcomes in Obstructive Sleep Apnea Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis of Comparative Studies. Anesth Analg. 2017 Dec;125(6):2030-2037.
Gupta K, Prasad A, Nagappa M, Wong J, Abrahamyan L, Chung F. Risk factors for opioid-induced respiratory depression and failure to rescue: a review. Curr Opin Anaesthesiol. 2017 Nov 7. PubMed PMID: 29120929.
Subramani Y, Nagappa M, Wong J, Patra J, Chung F. Death or near-death in patients with obstructive sleep apnoea: a compendium of case reports of critical complications. Br J Anaesth. 2017 Nov 1;119(5):885-899.
Nagappa M, Patra J, Wong J, Subramani Y, Singh M, Ho G, Wong DT, Chung F. Association of STOP-Bang Questionnaire as a Screening Tool for Sleep Apnea and Postoperative Complications: A Systematic Review and Bayesian Meta-analysis of Prospective and Retrospective Cohort Studies. Anesth Analg. 2017 Oct;125(4):1301-1308.
Subramani Y, Wong J, Nagappa M, Chung F. The Benefits of Perioperative Screening for Sleep Apnea in Surgical Patients. Sleep Med Clin. 2017 Mar;12(1):123-135. doi: 10.1016/j.jsmc.2016.10.003. Review. PubMed PMID: 28159091.
Sheshadri V, Tiwari AK, Nagappa M, Venkatraghavan L. Accuracy in Blood Pressure Monitoring: The Effect of Noninvasive Blood Pressure Cuff Inflation on Intra-arterial Blood Pressure Values. Anesth Essays Res. 2017 Jan-Mar;11(1):169-173.
Chung F, Memtsoudis SG, Ramachandran SK, Nagappa M, Opperer M, et al. Society of Anesthesia and Sleep Medicine Guidelines on Preoperative Screening and Assessment of Adult Patients With Obstructive Sleep Apnea. Anesth Analg. 2016 Aug;123(2):452-73.
Nagappa M, Mokhlesi B, Wong J et al. The effects of continuous positive airway pressure on postoperative outcomes in obstructive sleep apnea patients undergoing surgery: A systematic review and meta-analysis. Anesth Analg 2015;120:1013–23.
Nagappa M, Liao P, Wong J et al. Validation of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea among Different Populations: A Systematic Review and Meta-Analysis. PLoS One 2015;10.
Abdullah HR, Nagappa M, Siddiqui N et al. Diagnosis and treatment of obstructive sleep apnea during pregnancy. Curr Opin Anaesthesiol 2016;29:317–24.
Chung F, Nagappa M, Singh M, Mokhlesi B. CPAP in the perioperative setting: Evidence of support. Chest 2016;149:586–97.
For more PubMed publications, please visit: http://www.ncbi.nlm.nih.gov/pubmed/?term=Mahesh+nagappa
For more Google Scholar publications, please visit: https://scholar.google.ca/citations?user=Q0mVr4UAAAAJ&hl=en
