51 - 55 Pharmacology SBAs for the Primary FRCA

Last updated on 14 Jul 2025

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Question 51

You have returned from pre-op assessing your morning patients and are drawing up your standard cocktail of antiemetics. Your consultant asks whether you have completed an Apfel score for each of them, or if you're just drawing them up for fun.

Which of the following is not a risk factor for PONV in the Apfel score?

History of motion sickness
Female sex
Non-smoker
Use of volatile anaesthetics
Use of perioperative opioids

Answer

Use of volatile anaesthetics

This is not a risk factor included in the Apfel score, but there is decent evidence to suggest that volatiles do make PONV worse in those prone to getting it.

Female sex is the strongest independent risk factor for PONV, with a three times increased risk over males.

Here's the calculator.

Here's our post on PONV.