🤢 Postoperative Nausea & Vomiting Risk (Apfel simplified score)
UseSpecific treatment and doses follow current guidelines and local protocols; this page does not list them. [Pe…
SourceGan TJ, et al. Fourth Consensus Guidelines for the Management of PONV. Anesth Analg 2020.
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
Each additional risk factor raises PONV risk by roughly 20%. (original synthesis · not guideline verbatim)
When to use
Specific treatment and doses follow current guidelines and local protocols; this page does not list them. [Pending update] Unsourced specific doses/regimens on this page are temporarily hidden pending item-by-item review against the cited guideline texts.
How it works
One point each for female sex, non-smoker, history of PONV/motion sickness, and postoperative opioid use. 0/1/2/3/4 factors ≈ 10/20/40/60/80% PONV risk.
Key points
- Each additional risk factor raises PONV risk by roughly 20%. (original synthesis · not guideline verbatim)
- High-risk patients benefit from multimodal prophylaxis combining plus total intravenous anesthesia and opioid sparing.
- The score can be combined with the Koivuranta score, which adds age and surgery duration.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Female | No (0) |
|---|---|
| Non-smoker | No (smoker, 0) |
| History of PONV or motion sickness | No (0) |
| Postoperative opioid use | No (0) |
→Apfel0(0–4)
- PONV risk：0 factors → ≈10% (0/1/2/3/4 factors ≈ 10/20/40/60/80%)
- Prophylaxis direction：Low risk: routine management, single-agent prophylaxis if needed
- Note：Each additional risk factor raises PONV risk by ~20%. Can combine with the Koivuranta score (adding age, surgery duration)
| Female | Yes (1) |
|---|---|
| Non-smoker | Yes (non-smoker, 1) |
| History of PONV or motion sickness | Yes (1) |
| Postoperative opioid use | Yes (1) |
→Apfel4(0–4)
- PONV risk：4 factors → ≈80% (0/1/2/3/4 factors ≈ 10/20/40/60/80%)
- Prophylaxis direction：Specific treatment and doses follow current guidelines and local protocols; this page does not list them. [Pending update] Unsourced specific doses/regimens on this page are temporarily hidden pending item-by-item review against the cited guideline texts.
- Note：Each additional risk factor raises PONV risk by ~20%. Can combine with the Koivuranta score (adding age, surgery duration)
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Postoperative Nausea & Vomiting Risk (Apfel simplified score)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Postoperative Nausea & Vomiting Risk (Apfel simplified score) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.