Apfel score — PONV risk
Predicting postoperative nausea/vomiting risk
Mnemonic device
Female-Smoke-Sick-Strong
Mapping
Female
Female sex (1 pt)
Smoke
Non-smoker (1 pt)
Sick
History of PONV or motion sickness (1 pt)
Strong
Postoperative opioid planned (1 pt)
Clinical note: Score 0-4. Predicted PONV: 0=10%, 1=20%, 2=40%, 3=60%, 4=80%. Score 3-4 → multimodal antiemetic prophylaxis (3-4 different mechanisms).