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Post-Op Nausea Risk Calculator (PONV)
Estimate your chance of feeling sick or vomiting after surgery using the Apfel score. Tick the boxes that apply to you to see your risk and what to ask your anaesthesia team.
Each factor adds 1 point (score 0–4). Leave boxes unticked if you are unsure or they do not apply.
Frequently asked questions
What is the Apfel PONV score?
The Apfel simplified score uses four risk factors — female sex, being a non-smoker, a history of post-op nausea or motion sickness, and the likely need for opioid painkillers after surgery. Each factor counts as 1 point, giving a score from 0 to 4 that maps to an approximate chance of nausea or vomiting after surgery.
Why does being a non-smoker raise the risk?
Statistically, non-smokers have a higher rate of post-operative nausea and vomiting than smokers. This is just a pattern seen in research and is used to estimate risk — it is never a reason to start or continue smoking, which carries far greater harms.
What can lower my risk of nausea after surgery?
Anaesthesia teams can give anti-sickness (antiemetic) medicines before or during surgery, use techniques that need fewer opioids such as regional or nerve blocks, keep you well hydrated, and choose anaesthetic drugs less likely to cause nausea. Tell your team your history so they can plan ahead.
Is this calculator a diagnosis?
No. It is an educational estimate based on a validated scoring tool and population averages. Your actual risk depends on your surgery, anaesthetic plan, and individual health. Always discuss your situation with your anaesthetist or surgical team.