Anesthesia Considerations 

Identifying Patients at Risk ​

 

Apfel Simplified Risk Score for PONV. Risk factors are:

• Female Sex 

• History of PONV or Motion Sickness 

• Non-smoker

• Use of Postoperative Opioids 

 

Number of Apfel risk factors & risk of PONV: 

• 0 = 10%

• 1 = 20%

• 2 = 40% 

• 3 = 60% 

• 4 = 80% 

 

Other known risk factors: 

• Younger age <50 

• General anesthesia 

• Use of volatile anesthetics and nitrous oxide 

• Duration of anesthesia 

• Type of surgery (cholecystectomy, laparoscopic, gynecological) 

 

Risk categories based on number of risk factors: 

• Low: 0-1

• Medium: 2-3 

• High: 4 or more 

 

 

Adapted from Anesth Analg. August 2020 - Volume 131 - Issue 2 - p 411-448