Postoperative Nausea & Vomiting Risk (Apfel simplified score) — free guideline decision tool
The Apfel simplified score predicts postoperative nausea and vomiting (PONV) after general anesthesia from four risk factors, guiding the intensity of antiemetic prophylaxis.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Common questions
What does Postoperative Nausea & Vomiting Risk (Apfel simplified score) do?
Use preoperatively to estimate PONV risk and decide on single-agent versus multimodal prophylaxis and anesthetic technique (e.g. TIVA, opioid reduction).
How is the result calculated?
One point each for female sex, non-smoker, history of PONV/motion sickness, and postoperative opioid use. 0/1/2/3/4 factors ≈ 10/20/40/60/80% PONV risk.
Is this a substitute for clinical judgement?
No. All results are decision-support only, for licensed clinicians. They must be individualized to the whole patient and the latest guideline version.
Run Postoperative Nausea & Vomiting Risk (Apfel simplified score) now
The Apfel simplified score predicts postoperative nausea and vomiting (PONV) after general anesthesia from four risk factors, guiding the intensity of antiemetic prophylaxis.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.