Post-operative nausea and vomiting (PONV) is a common and distressing complication that significantly impacts patient well-being, particularly within the first 24 hours following surgery.

The primary goal of prophylactic measures against PONV is to reduce its occurrence, thereby enhancing the overall quality of patient care and facilitating smoother recovery processes. To address this issue, various predictive scoring systems have been developed to identify patients at higher risk of developing PONV, enabling more targeted prophylactic intervention.

 Among the most notable of these systems are those introduced by Apfel et al. in Germany and Koivuranta et al in Finland. These systems utilize specific risk factors to stratify patients according to their likelihood of experiencing PONV, thereby allowing clinicians to tailor prophylactic treatments to those most likely to benefit .

 The Apfel scoring system, in particular, has gained widespread acceptance and is frequently used in clinical settings. This system evaluates patients based on factors such as gender, history of motion sickness or PONV, non-smoking status, and the use of postoperative opioids, assigning a score that correlates with the patient’s risk level.

With this background, we plan to conduct this study to evaluate the effectiveness of Apfel score based prophylaxis versus universal prophylaxis to reduce the need of antiemetic for post operative nausea and vomiting in patients under general anaesthesia .

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