🤢 Apfel Score (Postoperative Nausea & Vomiting)
Predict postoperative nausea and vomiting with the simplified Apfel score.
Apfel Score (Postoperative Nausea & Vomiting)
Female sex
Non-smoker
History of PONV or motion sickness
Expected postoperative opioids
When to use
Guide multimodal PONV prophylaxis.
How it works
Female sex, non-smoker, history of PONV/motion sickness, expected postoperative opioids — each 1 point (0–4). Risk ≈ 10/21/39/61/79%.
Key points
- Each factor adds roughly 18–20% absolute risk.
- Scores ≥ 2 warrant multiple antiemetic classes.
- Consider opioid-sparing/TIVA for high risk.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.