Anaesthesia & ICU
Postoperative Nausea & Vomiting
Apfel score, multimodal prophylaxis, rescue antiemetics from different drug class.
Source: Society for Ambulatory Anesthesia 2020; AAGBI
Step 1 of ~5
info
Apfel Risk Score
1 point each: female sex, non-smoker, history of PONV / motion sickness, postoperative opioid use. Risk: 0=10%, 1=21%, 2=39%, 3=61%, 4=79%. Aim for proportional prophylaxis.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Phenylephrine · Alpha-1 Adrenergic Agonist (Pure Vasoconstrictor)
- Cyclizine (Nausea and Vomiting in Pregnancy) · Antihistamine Antiemetic — Hyperemesis Gravidarum
- Prochlorperazine (Nausea and Vomiting in Pregnancy) · Phenothiazine Antiemetic — Hyperemesis Gravidarum
- Salbutamol (Paediatric — Asthma/Wheeze) · Short-Acting Beta-2 Agonist (SABA)
- Ondansetron (Paediatric) · 5-HT3 Receptor Antagonist — Nausea / Vomiting / Gastroenteritis
- Lidocaine (IV — Anaesthesia/ICU) · Local Anaesthetic / Antiarrhythmic (Class Ib)
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Anaphylaxis Under Anaesthesia · AAGBI 2018; NAP6
- Malignant Hyperthermia · AAGBI 2011; MHAUS
- Local Anaesthetic Systemic Toxicity (LAST) · AAGBI 2010; ASRA 2017
- Spinal Anaesthesia Hypotension Management · AAGBI; ASA
- Surviving Sepsis Bundle (Adult ICU) · Surviving Sepsis Campaign 2021; NICE NG51
Decision support only. Always apply local guidelines and clinical judgement.