USEFULNESS OF APFEL SCORE FOR RISK STRATIFICATION AND PROPHYLACTIC ADMINISTRATION OF ANTI-EMETICS FOR PONV IN LAPAROSCOPIC GYNECOLOGICAL SURGERIES

Postoperative nausea & vomiting (PONV) is the 2nd most common distressing symptom commonly seen after surgeries under GA incidence being 20-30%.Apfel et.al (1999) developed a score that included 4 risk factors namely, female sex, h/o of PONV or motion sickness, nonsmoking status & use of postop opioids to predict the incidence of PONV.Apfel scoring system have been used to identify patient, anesthesia & surgery-related risk factors. This observational study was done with the primary aim of evaluating the usefulness of the Apfel score in identifying high-risk patients for PONV undergoing laparoscopic gynecological surgeries & to study efficacy in reducing the incidence of PONV after prophylactic administration of anti-emetics. Results: Out of 70 patients, observed incidence of PONV was 35.60% Complete response (i.e. complete absence of PONV for 24 hrs.) was 64.40% In our study, observed incidence of PONV was compared with the predicted incidence of PONV which was found to be statistically significant(P<0.05) Discussion:By using Apfel score we can objectively document patients who are at risk of PONV, guidelines can be followed for management of PONV with effective treatment strategies.administration of prophylactic antiemetics in patients who are at a high risk of PONV predicted by Apfel scoring system which will result in lowering the incidence of PONV achieving an ultimate goal to improve patients’ satisfaction