Evaluating the Incidence of Post-Operative Nausea and Vomiting in General and Regional Anaesthesia Using Apfel Scoring System and Post-Operative Nausea and Vomiting Intensity Scale -A Prospective Observational Study

Published on: September 2025

Authors and affiliation (s):

Sharmila Nirojini Palanisamy¹, Femina Hakkim¹, Gayathri Palani¹,^*, Jensilin Devakumari Thilagar¹, Jayaprakash Kuppusamy²

¹Department of Pharmacy Practice, Swamy Vivekanandha College of Pharmacy, Tiruchengode, Namakkal, Tamil Nadu, INDIA.

²Consultant Anaesthetist/ICU, Vivekanandha Medical Care Hospital, Tiruchengode, Namakkal, Tamil Nadu, INDIA.

ABSTRACT

Background: To evaluate the incidence of Post Operative Nausea and Vomiting in General and Regional anaesthesia using Apfel Scoring System and Post Operative Nausea and Vomiting Intensity Scale. Materials and Methods: A Prospective observational study was conducted in general surgery department at Vivekanandha Medical Care Hospital and Swamy Vivekanandha College of Pharmacy, Elayampalayam for a period of 6 months. 100 patients were recruited and their demographic details, type of anaesthesia and risk factors were monitored. The incidence of Post Operative Nausea and Vomiting (PONV) in patients who underwent surgery was assessed using the Apfel Scoring System and PONV intensity scale. The outcomes were studied and the data were analyzed using Graph Pad Prism. Results: In our study, which involved 100 patients, two groups were established: 50 underwent surgery with general anesthesia, and 50 with regional anesthesia. The majority of patients belonged to the 59 to 68 age group. We utilized the Apfel simplified scoring system to assess Post Operative Nausea and Vomiting risk in patients who had undergone both general and regional anesthesia. We then determined the incidence of Post Operative Nausea and Vomiting using a PONV intensity scale. Significantly, the Apfel simplified scoring system confirmed the suitability of the administered antiemetic drug for each patient in our study. Conclusion: Post Operative Nausea and Vomiting (PONV) is a significant challenge in surgery, impacting patient recovery and increasing healthcare costs. Our research found that Post Operative Nausea and Vomiting (PONV) incidence varies based on anesthesia type, with general anesthesia leading to higher rates compared to regional anesthesia. Additionally, regardless of anesthesia type, females consistently experienced higher Post operative nausea and vomiting rates than males, highlighting a gender-based trend.

Keywords: Post-operative nausea and vomiting, anaesthesia, Apfel scoring system, Intensity scale.