Post-op nausea and vomiting is associated with high levels of patient dissatisfaction, longer admissions and therefore higher costs to the medical system. 

Screen with the APFEL score + the other risk factors (younger age, type and length of surgery, anesthetic gases or nitrous exposure)

1+ risk factors? 2 prophylactic anti-emetics. 

3+ risk factors? 3-4 prophylactic anti-emetics. 

For rescue therapy within 6 hours post-op, use a different agent. 

References: 

1.  Butterworth J, Mackey D, Wasnick J. Morgan & Mikhail’s Clinical Anesthesiology. 5th ed. McGraw-Hill Education; 2013.

2.  Gan TJ, Belani KG, Bergese S, et al. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesth Analg. 2020;131(2):411-448. doi:10.1213/ANE.0000000000004833

3.  Barash P, Cullen B, Stoelting R. Clinical Anesthesia. 8th ed. Wolters Kluwer

Have questions, comments, corrections, or concerns? Please reach out via email:

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All research, scriptwriting and recording was by Blake Birnie, MD 2021 candidate at UBC's Southern Medical School Program