Apfel et al used a simple 4-item risk score to identify patients at increased risk for postoperative nausea and vomiting. This can help identify patients who may benefit from more aggressive management. The authors are from the Universities of Wuerzburg (Germany) and Oulu (Finland).
Parameters:
(1) gender
(2) smoking status
(3) previous history of PONV or motion sickness
(4) postoperative opioid use
Parameter |
Finding |
Points |
---|---|---|
gender |
male |
0 |
|
female |
1 |
smoking status |
smoker |
0 |
|
nonsmoker |
1 |
history of PONV or motion sickness |
absent |
0 |
|
present |
1 |
postoperative opioid use |
no |
0 |
|
yes |
1 |
number of risk factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The higher the number of risk factors, the higher the PONV risk.
Number of Risk Factors |
Risk of PONV |
---|---|
0 or 1 |
10 - 21% |
2 or more |
39-78% |
Management of a person at risk for PONV may include:
(1) change in anesthetic technique to one less likely to cause PONV, such as use of intravenous anesthesia with propofol
(2) administration of prophylactic antiemetic therapy
(3) change in analgesia to minimize the dose of postoperative opioids
Purpose: To evaluate a patient for risk of postoperative nausea and vomiting (PONV) using the simplified risk score of Apfel et al .
Specialty: Anesthesiology, Gastroenterology, Pharmacology, clinical
Objective: risk factors
ICD-10: R11, Z48,