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Apfel Score for Postoperative Nausea and Vomiting
Predicts risk of postoperative nausea and vomiting from four simple clinical predictors.
Apfel Score for Postoperative Nausea and Vomiting
Female sex
Nonsmoker
History of PONV or motion sickness
Postoperative opioids planned
Result0 risk factors
Approximate risk of PONV about 10%.
- Estimated PONV risk
- 10 %
When to use
- Estimating baseline risk of postoperative nausea and vomiting to guide prophylactic antiemetic strategy.
Formula
One point each for: female sex, nonsmoking status, history of PONV or motion sickness, planned postoperative opioids. Risk with 0/1/2/3/4 factors ~ 10%/21%/39%/61%/79%.
Pearls and pitfalls
- Derived and validated in adults undergoing balanced general anaesthesia; applies less well to regional-only or paediatric anaesthesia.
- Higher scores support multimodal antiemetic prophylaxis (combining agents from different classes).