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

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