PREDICTION OF POST-OPERATIVE NAUSEA & VOMITING USING APFEL SCORE

Background: Post-operative nausea vomiting (PONV) is the second most common complaint in patients undergoing general anaesthesia. The risk factors for PONV include female gender, no smoking history, post-operative use of opioids and history of previous PONV or motion sickness. One of the best-known scoring systems is developed by Apfel et al. Patients with high APFEL scores III or IV require multimodal treatment with more than one anti-emetic agent. Our study aims at validating the APFEL scoring system. Methods: All elective abdominal surgeries between January 2022 to June 2022 under general anaesthesia were included. Patients were scored based on the simplied APFEL scoring system. No prophylactic anti-emetic and post-operative opioids were administered. Based on this scoring system, patients were allocated to one of the 4 groups (Group 1- score 0-1/4; Group 2- score 2/4; Group 3- score 3/4; Group 4- score 4/4). Further, patients were assessed every hour, for the incidence of nausea and vomiting 24 hours after discharge from the Operating Room, based on a standard questionnaire, interviewed by the anaesthesiologist. Graded as 0 - No nausea; 1- Nausea present; 2- Nausea & Vomiting both present Results: There is a correlation between the incidence of postoperative nausea and vomiting, versus the calculated Predicted APFEL score. Conclusion: A validated scoring system like the APFEL score can successfully predict the population at risk and thus reduce the incidence of postoperative nausea and vomiting, being a simplied tool for the stratication of patients with a high risk for PONV.