BACKGROUND: In the previous study, patients at high risk for postoperative nausea and vomiting (PONV) were identified by the Korean risk model. Consecutively, we investigated whether high-risk patients based on the Korean risk model could be managed with multiple prophylactic antiemetics.

METHODS: Patients scheduled for elective surgery under general anesthesia were classified in two risk groups (first group: high risk group, second group: very high risk group) by using the Korean risk model. All patients received volatile general anesthesia and antiemetic combination of dexamethasone 5 mg (after induction) and ondansetron 4 mg (before end of surgery). We investigated the incidences of PONV in the postanesthetic care unit and at ward.

RESULTS: Compared with the data from our previous study, the overall incidence of PONV decreased from 52.2% to 23.1% (P≤0.001). The incidence decreased from 47.4% to 19.4% (P≤0.001) in the high risk group and from 61.6% to 32.2% (P≤0.001) in the very high risk group. The relative risk reduction did not differ between two groups (59.1%:47.7%).

CONCLUSIONS: Antiemetic prophylactic with combination of dexamethasone and ondansetron was equally effective in reducing the occurrence of PONV in both group patients.