Anaes Cases · Postoperative nausea & vomiting
The high-risk PONV patient for the laparoscopic surgery
The long case — the Apfel 4 (the female, the non-smoker, the PONV history, the expected opioid). The multicomponent prophylaxis (the dexamethasone, the ondansetron, the aprepitant), the TIVA, the opioid-sparing, the sugammadex, and the rescue plan.
On this page
Study tools
Target exams
ANZCAFRCAABAEDAIC
Prompt
A 35-year-old non-smoking woman with the previous PONV for the laparoscopic gynaecological surgery. Discuss the prophylaxis plan.
Presentation
A 35-year-old non-smoking woman with the previous severe PONV after her caesarean section, for the elective laparoscopic ovarian cystectomy. Discuss the PONV prophylaxis plan.
References2ShowHide
- [1]Dombrower R, et al. Perioperative Anesthesia Strategies for the Prevention of Postoperative Nausea and Vomiting Within Enhanced Recovery After Surgery Pathways: A Clinical Narrative Review. J Clin Med, 2026.PMID 42194789
- [2]Grigio TR, et al. Aprepitant and fosaprepitant as a prophylactic antiemetic for preventing postoperative nausea and vomiting after general anaesthesia: a systematic review and meta-analysis. Clinics, 2025.PMID 41100974