{"id":728,"date":"2026-08-20T17:07:01","date_gmt":"2026-08-20T15:07:01","guid":{"rendered":"https:\/\/4beauty.de\/glossar\/postoperative-uebelkeit\/"},"modified":"2026-08-28T11:53:48","modified_gmt":"2026-08-28T09:53:48","slug":"post-operative-nausea","status":"publish","type":"glossary","link":"https:\/\/4beauty.de\/en\/glossar\/postoperative-uebelkeit\/","title":{"rendered":"Post-operative nausea and vomiting (PONV): definition, risk factors and treatment"},"content":{"rendered":"<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Post-operative nausea and vomiting (PONV):<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Post-operative nausea refers to nausea, retching or vomiting that occurs within the first 24 hours following a surgical procedure under general anaesthesia. PONV affects around 30 % of all patients following general anaesthesia and is one of the most common complications in the recovery room.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-rank-math-toc-block\" id=\"rank-math-toc\"><h2>Table of Contents<\/h2><nav><ul><li class=\"\"><a href=\"#wie-haufig-tritt-ponv-auf\">How common is PONV?<\/a><\/li><li class=\"\"><a href=\"#wie-entsteht-postoperative-ubelkeit\">What causes post-operative nausea?<\/a><\/li><li class=\"\"><a href=\"#risikofaktoren-und-risikoeinschatzung-apfel-score-und-koivuranta-score\">Risk factors and risk assessment: the Apfel score and the Koivuranta score<\/a><\/li><li class=\"\"><a href=\"#prophylaxe-so-wird-postoperative-ubelkeit-verhindert\">Prevention: How to prevent post-operative nausea<\/a><\/li><li class=\"\"><a href=\"#therapie-behandlung-bei-aufgetretener-ponv\">Treatment: Management of PONV once it has occurred<\/a><\/li><li class=\"\"><a href=\"#komplikationen-wann-wird-postoperative-ubelkeit-gefahrlich\">Complications: When does post-operative nausea become dangerous?<\/a><\/li><li class=\"\"><a href=\"#postoperative-ubelkeit-nach-schonheitsoperationen-was-bedeutet-das-fur-sie\">Post-operative nausea following cosmetic surgery: what does this mean for you?<\/a><\/li><li class=\"\"><a href=\"#haufig-gestellte-fragen-zu-postoperativer-ubelkeit\">Frequently asked questions about post-operative nausea<\/a><\/li><\/ul><\/nav><\/div>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-white-warm-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Important note<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This article is for information purposes only and is not a substitute for a medical diagnosis or advice. If you are unsure, or if you require a personalised treatment plan, it is essential that you consult a qualified specialist.<\/p>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Post-operative nausea is one of the complications about which patients are rarely given sufficient information prior to surgery. Yet, statistically, it affects one in three people following general anaesthesia, and the figure is significantly higher for certain procedures, such as gynaecological or abdominal surgery. Anyone planning cosmetic surgery should be aware of the causes, risk factors and possible consequences so that they are well prepared.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-pflegeperson-betreut-patientin-im-aufwachraum-nach-einer-ope.png\" alt=\"A nurse is looking after a patient in the recovery room following an operation; post-operative nausea (PONV) care\" class=\"wp-image-485\" srcset=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-pflegeperson-betreut-patientin-im-aufwachraum-nach-einer-ope.png 1536w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-pflegeperson-betreut-patientin-im-aufwachraum-nach-einer-ope-900x600.png 900w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-pflegeperson-betreut-patientin-im-aufwachraum-nach-einer-ope-300x200.png 300w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-pflegeperson-betreut-patientin-im-aufwachraum-nach-einer-ope-768x512.png 768w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-pflegeperson-betreut-patientin-im-aufwachraum-nach-einer-ope-1024x683.png 1024w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-pflegeperson-betreut-patientin-im-aufwachraum-nach-einer-ope-18x12.png 18w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-pflegeperson-betreut-patientin-im-aufwachraum-nach-einer-ope-40x27.png 40w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"wie-haufig-tritt-ponv-auf\">How common is PONV?<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<ul class=\"wp-block-list\">\n<li>Around 30 % of all patients following general anaesthesia are affected<\/li>\n\n\n\n<li>For high-risk groups, the rate rises to 70\u201380 %<\/li>\n\n\n\n<li>Alongside pain, PONV is one of the most commonly reported symptoms following surgery<\/li>\n\n\n\n<li>Without targeted preventive measures, the incidence for certain procedures is over 60 %<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Post-operative nausea and vomiting, medically referred to as PONV (Post-operative Nausea and Vomiting), are among the most common adverse events following surgical procedures. According to data from the medical literature, PONV affects on average 30 % of all patients undergoing surgery under general anaesthesia. In individuals with multiple risk factors, this rate rises to 70\u201380 %.<\/p>\n\n\n\n<svg aria-label=\"PONV-Risiko nach Apfel-Score: Inzidenzraten von 10 bis 79 Prozent je nach Anzahl der Risikofaktoren\" font-family=\"'Montserrat', system-ui, sans-serif\" role=\"img\" viewbox=\"0 0 780 380\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><title>Risk of PONV according to the Apple Score<\/title><desc>The bar chart shows the incidence of PONV for 0 to 4 risk factors on the Apple Score: 10%, 21%, 39%, 61%, 79%<\/desc><rect fill=\"#f9fafb\" height=\"380\" rx=\"8\" width=\"780\"><\/rect><text fill=\"#333333\" font-family=\"'Roboto Slab', Georgia, serif\" font-size=\"17\" font-weight=\"600\" text-anchor=\"middle\" x=\"390\" y=\"38\">Risk of PONV according to the Apple Score<\/text><text fill=\"#888888\" font-size=\"12\" text-anchor=\"middle\" x=\"390\" y=\"58\">Probability of post-operative nausea depending on the number of risk factors<\/text><line stroke=\"#e4e4e4\" stroke-dasharray=\"4 4\" stroke-width=\"1\" x1=\"100\" x2=\"740\" y1=\"80\" y2=\"80\"><\/line><line stroke=\"#e4e4e4\" stroke-dasharray=\"4 4\" stroke-width=\"1\" x1=\"100\" x2=\"740\" y1=\"130\" y2=\"130\"><\/line><line stroke=\"#e4e4e4\" stroke-dasharray=\"4 4\" stroke-width=\"1\" x1=\"100\" x2=\"740\" y1=\"180\" y2=\"180\"><\/line><line stroke=\"#e4e4e4\" stroke-dasharray=\"4 4\" stroke-width=\"1\" x1=\"100\" x2=\"740\" y1=\"230\" y2=\"230\"><\/line><line stroke=\"#e4e4e4\" stroke-dasharray=\"4 4\" stroke-width=\"1\" x1=\"100\" x2=\"740\" y1=\"280\" y2=\"280\"><\/line><text fill=\"#888888\" font-size=\"11\" text-anchor=\"end\" x=\"90\" y=\"84\">100%<\/text><text fill=\"#888888\" font-size=\"11\" text-anchor=\"end\" x=\"90\" y=\"134\">75%<\/text><text fill=\"#888888\" font-size=\"11\" text-anchor=\"end\" x=\"90\" y=\"184\">50%<\/text><text fill=\"#888888\" font-size=\"11\" text-anchor=\"end\" x=\"90\" y=\"234\">25%<\/text><text fill=\"#888888\" font-size=\"11\" text-anchor=\"end\" x=\"90\" y=\"284\">0%<\/text><line stroke=\"#e4e4e4\" stroke-width=\"1.5\" x1=\"100\" x2=\"740\" y1=\"280\" y2=\"280\"><\/line><line stroke=\"#e4e4e4\" stroke-width=\"1.5\" x1=\"100\" x2=\"100\" y1=\"80\" y2=\"280\"><\/line><rect fill=\"#a5d6a7\" height=\"20\" rx=\"4\" width=\"80\" x=\"130\" y=\"260\"><animate attributename=\"height\" begin=\"0.1s\" dur=\"0.7s\" fill=\"freeze\" from=\"0\" to=\"20\"><\/animate><animate attributename=\"y\" begin=\"0.1s\" dur=\"0.7s\" fill=\"freeze\" from=\"280\" to=\"260\"><\/animate><\/rect><text fill=\"#1b5e20\" font-size=\"13\" font-weight=\"700\" text-anchor=\"middle\" x=\"170\" y=\"254\">10%<\/text><text fill=\"#888888\" font-size=\"11\" text-anchor=\"middle\" x=\"170\" y=\"298\">0 factors<\/text><text fill=\"#999999\" font-size=\"10\" text-anchor=\"middle\" x=\"170\" y=\"312\">low risk<\/text><rect fill=\"#c5e1a5\" height=\"42\" rx=\"4\" width=\"80\" x=\"242\" y=\"238\"><animate attributename=\"height\" begin=\"0.2s\" dur=\"0.7s\" fill=\"freeze\" from=\"0\" to=\"42\"><\/animate><animate attributename=\"y\" begin=\"0.2s\" dur=\"0.7s\" fill=\"freeze\" from=\"280\" to=\"238\"><\/animate><\/rect><text fill=\"#33691e\" font-size=\"13\" font-weight=\"700\" text-anchor=\"middle\" x=\"282\" y=\"232\">21%<\/text><text fill=\"#888888\" font-size=\"11\" text-anchor=\"middle\" x=\"282\" y=\"298\">1 factor<\/text><text fill=\"#999999\" font-size=\"10\" text-anchor=\"middle\" x=\"282\" y=\"312\">slightly elevated<\/text><rect fill=\"#ffe082\" height=\"78\" rx=\"4\" width=\"80\" x=\"354\" y=\"202\"><animate attributename=\"height\" begin=\"0.3s\" dur=\"0.7s\" fill=\"freeze\" from=\"0\" to=\"78\"><\/animate><animate attributename=\"y\" begin=\"0.3s\" dur=\"0.7s\" fill=\"freeze\" from=\"280\" to=\"202\"><\/animate><\/rect><text fill=\"#f57f17\" font-size=\"13\" font-weight=\"700\" text-anchor=\"middle\" x=\"394\" y=\"196\">39%<\/text><text fill=\"#888888\" font-size=\"11\" text-anchor=\"middle\" x=\"394\" y=\"298\">2 factors<\/text><text fill=\"#999999\" font-size=\"10\" text-anchor=\"middle\" x=\"394\" y=\"312\">medium risk<\/text><rect fill=\"#ffcc80\" height=\"122\" rx=\"4\" width=\"80\" x=\"466\" y=\"158\"><animate attributename=\"height\" begin=\"0.4s\" dur=\"0.7s\" fill=\"freeze\" from=\"0\" to=\"122\"><\/animate><animate attributename=\"y\" begin=\"0.4s\" dur=\"0.7s\" fill=\"freeze\" from=\"280\" to=\"158\"><\/animate><\/rect><text fill=\"#e65100\" font-size=\"13\" font-weight=\"700\" text-anchor=\"middle\" x=\"506\" y=\"152\">61%<\/text><text fill=\"#888888\" font-size=\"11\" text-anchor=\"middle\" x=\"506\" y=\"298\">3 factors<\/text><text fill=\"#999999\" font-size=\"10\" text-anchor=\"middle\" x=\"506\" y=\"312\">high risk<\/text><rect fill=\"#f14d97\" height=\"158\" rx=\"4\" width=\"80\" x=\"578\" y=\"122\"><animate attributename=\"height\" begin=\"0.5s\" dur=\"0.7s\" fill=\"freeze\" from=\"0\" to=\"158\"><\/animate><animate attributename=\"y\" begin=\"0.5s\" dur=\"0.7s\" fill=\"freeze\" from=\"280\" to=\"158\"><\/animate><\/rect><text fill=\"#f14d97\" font-size=\"13\" font-weight=\"700\" text-anchor=\"middle\" x=\"618\" y=\"116\">79%<\/text><text fill=\"#888888\" font-size=\"11\" text-anchor=\"middle\" x=\"618\" y=\"298\">4 factors<\/text><text fill=\"#999999\" font-size=\"10\" text-anchor=\"middle\" x=\"618\" y=\"312\">very high risk<\/text><text fill=\"#aaaaaa\" font-size=\"10\" text-anchor=\"middle\" x=\"390\" y=\"365\">Apple Score (Apfel et al.), as at July 2026 | 4beauty.com<\/text><\/svg>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Incidence of PONV according to the Apfel score: The likelihood of post-operative nausea increases significantly with each additional risk factor.<\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-etwa-30-prozent-der-patienten-unter-allgemeinan-sthesie-entw.png\" alt=\"Around 30 per cent of patients undergoing general anaesthesia experience post-operative nausea.\" class=\"wp-image-506\" srcset=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-etwa-30-prozent-der-patienten-unter-allgemeinan-sthesie-entw.png 1536w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-etwa-30-prozent-der-patienten-unter-allgemeinan-sthesie-entw-900x600.png 900w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-etwa-30-prozent-der-patienten-unter-allgemeinan-sthesie-entw-300x200.png 300w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-etwa-30-prozent-der-patienten-unter-allgemeinan-sthesie-entw-768x512.png 768w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-etwa-30-prozent-der-patienten-unter-allgemeinan-sthesie-entw-1024x683.png 1024w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-etwa-30-prozent-der-patienten-unter-allgemeinan-sthesie-entw-18x12.png 18w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-etwa-30-prozent-der-patienten-unter-allgemeinan-sthesie-entw-40x27.png 40w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">PONV is particularly relevant in the case of procedures that are frequently carried out in a cosmetic context: According to clinical studies, laparoscopic surgery (e.g. in the abdominal region), gynaecological procedures and abdominal surgical procedures such as abdominoplasty are considered high-risk procedures for PONV. Without targeted preventive measures, the incidence of PONV in these procedures can exceed 60 %.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The economic impact is significant: studies show that PONV, on average, prolongs the stay in the recovery room and, in some cases, may necessitate unplanned admission to hospital. For patients who had planned to undergo cosmetic surgery on an outpatient basis, this means additional costs that they must bear themselves, as statutory health insurance does not cover cosmetic surgery.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"wie-entsteht-postoperative-ubelkeit\">What causes post-operative nausea?<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Key points at a glance:<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>The vomiting centre in the medulla oblongata processes stimuli from several sources simultaneously<\/li>\n\n\n\n<li>Inhalation anaesthetics, nitrous oxide and opioids are the most potent pharmacological triggers<\/li>\n\n\n\n<li>General anaesthesia causes significantly more PONV than regional anaesthesia or TIVA<\/li>\n\n\n\n<li>Operational factors such as the duration of the procedure and the area of the body also influence the risk<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Post-operative nausea arises from a complex interplay of neural and pharmacological processes. A key factor in this is the <strong>Emergency Centre<\/strong>, a region in the medulla oblongata of the brainstem that receives and coordinates signals from various sources. These signals originate from the gastrointestinal tract, the vestibular system and the chemoreceptor trigger zone (CTZ), which is located in the area postrema of the brainstem.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-vereinfachte-darstellung-des-gehirns-zeigt-das-brechzentrum-.png\" alt=\"A simplified diagram of the brain shows the vomiting centre in the medulla oblongata as the trigger for PONV.\" class=\"wp-image-539\" srcset=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-vereinfachte-darstellung-des-gehirns-zeigt-das-brechzentrum-.png 1536w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-vereinfachte-darstellung-des-gehirns-zeigt-das-brechzentrum--900x600.png 900w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-vereinfachte-darstellung-des-gehirns-zeigt-das-brechzentrum--300x200.png 300w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-vereinfachte-darstellung-des-gehirns-zeigt-das-brechzentrum--768x512.png 768w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-vereinfachte-darstellung-des-gehirns-zeigt-das-brechzentrum--1024x683.png 1024w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-vereinfachte-darstellung-des-gehirns-zeigt-das-brechzentrum--18x12.png 18w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-vereinfachte-darstellung-des-gehirns-zeigt-das-brechzentrum--40x27.png 40w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">The CTZ is particularly sensitive to chemical substances in the blood. Anaesthetics, in particular <strong>Inhalation anaesthetics<\/strong> Such as isoflurane or sevoflurane, as well as nitrous oxide, directly stimulate the CTZ. The same applies to opioids (e.g. morphine or fentanyl), which are frequently used for post-operative pain management. This is why PONV remains an issue even long after the operation itself has finished.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"drei-ursachenkategorien-im-uberblick\">An overview of three categories of causes<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Medical societies distinguish between three main categories of triggers that contribute to PONV:<\/p>\n\n\n\n<div class=\"wp-block-group is-layout-grid wp-container-core-group-is-layout-0ddedb66 wp-block-group-is-layout-grid\">\n<div class=\"wp-block-group is-style-boxed has-white-warm-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Patient-related factors<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Female gender; non-smoker status; history of PONV or travel sickness; younger age; pre-operative anxiety<\/p>\n<\/div>\n\n<div class=\"wp-block-group is-style-boxed has-white-warm-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Anaesthesia-related factors<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Inhalation anaesthetics (sevoflurane, isoflurane); nitrous oxide; intraoperative and postoperative opioids; prolonged duration of anaesthesia<\/p>\n<\/div>\n\n<div class=\"wp-block-group is-style-boxed has-white-warm-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Operational factors<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Laparoscopic procedures; gynaecological operations; abdominal surgery; ENT operations; procedures near the vestibular system<\/p>\n<\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">It is important to understand that PONV is not a sign that the anaesthesia has been administered incorrectly. It is a biologically based reaction that can occur despite the most careful preparation. For patients planning cosmetic procedures under general anaesthesia, such as liposuction, this is a relevant factor to consider when weighing up the risks.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"risikofaktoren-und-risikoeinschatzung-apfel-score-und-koivuranta-score\">Risk factors and risk assessment: the Apfel score and the Koivuranta score<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Key points at a glance:<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>The Apple Score is the most widely used tool for assessing the risk of PONV in adults<\/li>\n\n\n\n<li>It comprises four factors; even two of these factors indicate a risk of 40 %<\/li>\n\n\n\n<li>The Koivuranta Score expands the assessment to five factors<\/li>\n\n\n\n<li>Both scores serve as a basis for anaesthetists when deciding on prophylaxis<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Anaesthetists use standardised scoring systems to systematically assess an individual\u2019s risk of PONV. The best-known of these is the <strong>Apple Score<\/strong>, which assesses four clearly defined factors.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-die-vier-risikofaktoren-des-apfel-scores-zur-einsch-tzung-de.png\" alt=\"The four risk factors in the Apple Score for assessing the risk of PONV prior to surgery.\" class=\"wp-image-545\" srcset=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-die-vier-risikofaktoren-des-apfel-scores-zur-einsch-tzung-de.png 1536w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-die-vier-risikofaktoren-des-apfel-scores-zur-einsch-tzung-de-900x600.png 900w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-die-vier-risikofaktoren-des-apfel-scores-zur-einsch-tzung-de-300x200.png 300w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-die-vier-risikofaktoren-des-apfel-scores-zur-einsch-tzung-de-768x512.png 768w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-die-vier-risikofaktoren-des-apfel-scores-zur-einsch-tzung-de-1024x683.png 1024w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-die-vier-risikofaktoren-des-apfel-scores-zur-einsch-tzung-de-18x12.png 18w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-die-vier-risikofaktoren-des-apfel-scores-zur-einsch-tzung-de-40x27.png 40w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"apfel-score-die-vier-risikofaktoren\">Apple Score: The four risk factors<\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Risk factor<\/th><th>Explanation<\/th><\/tr><\/thead><tbody><tr><td>Female gender<\/td><td>Due to hormonal factors, women are affected significantly more often than men<\/td><\/tr><tr><td>Non-smoker status<\/td><td>Smoking appears to have a certain protective effect; the exact mechanism is not yet fully understood<\/td><\/tr><tr><td>A history of PONV or travel sickness<\/td><td>Anyone who has experienced nausea following anaesthesia in the past or who is prone to travel sickness is at increased risk<\/td><\/tr><tr><td>Post-operative opioid administration<\/td><td>Opioid painkillers (e.g. morphine) increase the risk of PONV following surgery<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"apfel-score-wahrscheinlichkeit-je-faktorenzahl\">Apple Score: Probability per number of factors<\/h3>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Number of risk factors<\/th><th>Probability of PONV<\/th><th>At-risk group<\/th><\/tr><\/thead><tbody><tr><td>0<\/td><td>approx. 10 %<\/td><td>Low risk<\/td><\/tr><tr><td>1<\/td><td>approx. 20 %<\/td><td>Low risk<\/td><\/tr><tr><td>2<\/td><td>approx. 40 %<\/td><td>Medium risk<\/td><\/tr><tr><td>3<\/td><td>approx. 60\u201370 %<\/td><td>High risk<\/td><\/tr><tr><td>4<\/td><td>approx. 80 %<\/td><td>Very high risk<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">For female patients planning cosmetic surgery under general anaesthesia: according to the Apfel Score, being female and a non-smoker combined already results in a moderate risk of around 40 %. Added to this are surgical factors such as the type of procedure. This highlights how important it is to carry out a risk assessment before the procedure.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"koivuranta-score-ein-erganzendes-instrument\">The Koivuranta Score: A supplementary tool<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The <strong>Koivuranta Score<\/strong> adds a fifth factor to the Apple Score: procedures lasting more than 60 minutes. Many cosmetic procedures, including extensive liposuction or combined operations, exceed this threshold. The Koivuranta system is therefore particularly useful for pre-operative planning in the field of aesthetic surgery. Both scores achieve an accuracy of around 70 %; they should therefore be regarded as a guide rather than an absolute prediction.<\/p>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-anchor-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Information for patients:<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Before the operation, please tell your doctor if you have suffered from nausea following anaesthesia in the past or if you are prone to travel sickness. This information is crucial in deciding on the appropriate preventative treatment.<\/p>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"prophylaxe-so-wird-postoperative-ubelkeit-verhindert\">Prevention: How to prevent post-operative nausea<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<ul class=\"wp-block-list\">\n<li>Pharmacological prophylaxis with 5-HT3 antagonists (e.g. ondansetron) and dexamethasone is considered the standard of care<\/li>\n\n\n\n<li>For high-risk patients, the DGAI recommends dual prophylaxis using two different classes of active substances<\/li>\n\n\n\n<li>TIVA (total intravenous anaesthesia) with propofol significantly reduces the risk of PONV compared with inhalation anaesthetics<\/li>\n\n\n\n<li>Non-pharmacological measures such as acupressure complement pharmacological prophylaxis<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">The prevention of post-operative nausea begins even before the incision is made. Anaesthetists assess the individual risk and adjust the anaesthesia management and accompanying medication accordingly. According to the guidelines issued by the Scientific Working Group on Paediatric Anaesthesia of the DGAI (German Society for Anaesthesiology and Intensive Care Medicine, 2023), high-risk patients should receive <strong>Dual prophylaxis<\/strong> The standard approach involves two different classes of antiemetic active substances.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-ein-an-sthesist-bereitet-im-operationssaal-eine-intraven-se-.png\" alt=\"An anaesthetist is preparing an intravenous prophylactic treatment in the operating theatre to prevent post-operative nausea.\" class=\"wp-image-560\" srcset=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-ein-an-sthesist-bereitet-im-operationssaal-eine-intraven-se-.png 1536w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-ein-an-sthesist-bereitet-im-operationssaal-eine-intraven-se--900x600.png 900w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-ein-an-sthesist-bereitet-im-operationssaal-eine-intraven-se--300x200.png 300w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-ein-an-sthesist-bereitet-im-operationssaal-eine-intraven-se--768x512.png 768w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-ein-an-sthesist-bereitet-im-operationssaal-eine-intraven-se--1024x683.png 1024w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-ein-an-sthesist-bereitet-im-operationssaal-eine-intraven-se--18x12.png 18w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-ein-an-sthesist-bereitet-im-operationssaal-eine-intraven-se--40x27.png 40w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"medikamentose-prophylaxe-die-wichtigsten-wirkstoffgruppen\">Pharmacological prophylaxis: the main classes of active substances<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>5-HT3 antagonists<\/strong> Like ondansetron and granisetron, they block serotonin receptors in the chemoreceptor trigger zone. They are regarded as the most effective single class of drugs for treating PONV and are routinely used in many hospitals. <strong>Dexamethasone<\/strong>, a corticosteroid, complements the treatment well and, when used in combination with a 5-HT3 antagonist, is significantly more effective than either drug on its own. <strong>Droperidol<\/strong>, a dopamine antagonist, is also used, but less frequently than in the past, due to the need for cardiac monitoring.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Metoclopramide, known to many as a home remedy for nausea, is now rarely used in perioperative prophylaxis, as it is less effective than the newer 5-HT3 antagonists.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"anasthesiologische-basismassnahmen-zur-ponv-reduktion\">Basic anaesthetic measures to reduce PONV<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">In addition to medication, there are anaesthetic strategies that structurally reduce the risk of PONV:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>TIVA (Total Intravenous Anaesthesia) with propofol<\/strong> Unlike inhalation anaesthetics, propofol itself has mild antiemetic properties<\/li>\n\n\n\n<li>Avoid nitrous oxide (N\u2082O), one of the most potent triggers of PONV<\/li>\n\n\n\n<li>Keep intraoperative and postoperative opioid use to a minimum; favour multimodal pain management<\/li>\n\n\n\n<li>Adequate fluid intake before and during the operation<\/li>\n\n\n\n<li>Give preference to regional anaesthesia wherever medically feasible<\/li>\n<\/ol>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"nicht-medikamentose-alternativen-akupressur-und-ingwer\">Non-medicinal alternatives: acupressure and ginger<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Acupressure on the <strong>Point P6<\/strong> (Nei-Kuan point on the wrist) has been shown in several clinical trials to be moderately effective in reducing post-operative nausea. Special acupressure bands can provide continuous stimulation of this point. The effect is weaker than that of pharmacological prophylaxis, but there are no side effects. Ginger extract is also under consideration; the available evidence is not yet conclusive enough to warrant a clear recommendation, but the risk profile is favourable. Both methods are suitable as a supplement to pharmacological prophylaxis, but do not replace it in high-risk patients.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"therapie-behandlung-bei-aufgetretener-ponv\">Treatment: Management of PONV once it has occurred<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<ul class=\"wp-block-list\">\n<li>If PONV occurs, antiemetics from a different class of active substances to those used for prophylaxis are administered<\/li>\n\n\n\n<li>Ondansetron is the most commonly used rescue medication in the recovery room<\/li>\n\n\n\n<li>Non-pharmacological measures support recovery<\/li>\n\n\n\n<li>If vomiting persists for more than 24 hours, it is essential to seek medical advice<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">If PONV occurs despite prophylaxis, specific treatment begins in the <strong>Recovery room<\/strong> (PACU, Post-Anaesthetic Care Unit). As a general rule, if a 5-HT3 antagonist has already been used for prophylaxis, a substance from a different class of active ingredients should be used for treatment in order to achieve an additive effect.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"medikamentose-therapie-im-aufwachraum\">Medication in the recovery room<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Ondansetron (a 5-HT3 antagonist) is the most commonly used rescue medication. It acts quickly and has a favourable side-effect profile. Alternatively, dexamethasone, dimenhydrinate or, in severe cases, droperidol may be used. The choice depends on which substances have already been administered for prophylaxis. Metoclopramide can be used as a supplementary option, but is less effective.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"unterstutzende-massnahmen-ohne-medikamente\">Non-pharmacological supportive measures<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">As well as medication, simple measures can help to relieve the symptoms. Fresh air or a cool flannel on the face can help to reduce the urge to vomit. Sitting up slowly rather than standing up abruptly prevents dizziness from making the nausea worse. Clear fluids in small amounts help to prevent dehydration, provided the vomiting has subsided. Solid food should not be eaten until the nausea has significantly eased.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If vomiting persists for several hours or occurs more than three times within 24 hours, medical advice should be sought. Severe vomiting can lead to dehydration and electrolyte imbalances, which, in rare cases, may require medical treatment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"komplikationen-wann-wird-postoperative-ubelkeit-gefahrlich\">Complications: When does post-operative nausea become dangerous?<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<ul class=\"wp-block-list\">\n<li>Aspiration of gastric contents is the most serious medical complication (Mendelson\u2019s syndrome)<\/li>\n\n\n\n<li>Severe retching can compromise surgical stitches and delay healing<\/li>\n\n\n\n<li>Dehydration caused by persistent vomiting requires medical attention<\/li>\n\n\n\n<li>Longer recovery times and unplanned hospital admissions increase treatment costs<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Post-operative nausea is unpleasant for most patients, but it is temporary. In a minority of cases, however, PONV can lead to serious consequences.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"medizinische-komplikationen-durch-ponv\">Medical complications caused by PONV<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The most dangerous complication is the <strong>Aspiration<\/strong>: If stomach contents enter the airways during vomiting, this can trigger chemical pneumonia, which is known as <strong>Mendelson syndrome<\/strong> is well known. This risk is the main reason why patients must fast for several hours before surgery. Persistent retching can also put pressure on freshly sutured wounds; this is a particularly relevant factor following abdominal surgery or a breast lift. Wound dehiscence \u2013 that is, the tearing open of sutured wounds \u2013 is a possible consequence.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Dehydration and electrolyte imbalance occur during prolonged vomiting, when the body loses too much fluid and minerals. In severe cases, intravenous fluid replacement is necessary.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"okonomische-folgen-wer-tragt-die-kosten\">Economic consequences: Who bears the costs?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">PONV also has a financial aspect that is often underestimated. A prolonged stay in the recovery room ties up nursing staff and resources. If patients have to be admitted as inpatients unexpectedly following a cosmetic procedure originally planned as an outpatient procedure, this results in additional costs. In the case of privately funded cosmetic surgery, these costs are not covered by health insurance but are borne by the patient themselves.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is precisely where the principle of follow-up costs insurance for cosmetic procedures comes into play: it covers medically necessary treatment arising as a result of the insured procedure, regardless of whether the complication was foreseeable or not.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"postoperative-ubelkeit-nach-schonheitsoperationen-was-bedeutet-das-fur-sie\">Post-operative nausea following cosmetic surgery: what does this mean for you?<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<ul class=\"wp-block-list\">\n<li>Procedures such as liposuction, tummy tucks and breast surgery are among the high-risk procedures for PONV<\/li>\n\n\n\n<li>General anaesthesia is standard practice for many cosmetic procedures, which automatically increases the risk of PONV<\/li>\n\n\n\n<li>PONV is not uncommon and is not a glitch, but the resulting costs can be substantial<\/li>\n\n\n\n<li>Follow-on costs insurance provides cover against unexpected treatment costs<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Many cosmetic procedures are carried out under general anaesthesia. This applies to liposuction, extensive tummy tucks, breast augmentation and combined procedures. These operations fall into several categories that are clinically considered to carry an increased risk of PONV: they involve the abdominal cavity, often last more than 60 minutes and require deep general anaesthesia.<\/p>\n\n\n\n<div data-wp-context=\"{ &quot;autoclose&quot;: false, &quot;accordionItems&quot;: [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-1&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-1-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-1\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Does the statutory health insurance scheme cover the costs of treatment for post-operative nausea?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-1\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-1-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">This depends crucially on whether the original procedure was medically necessary or carried out at the patient\u2019s own request. In the case of cosmetic surgery paid for privately, the following applies: if post-operative nausea arises as a complication, the costs of follow-up treatment can be claimed back from the health insurance fund, even if the nausea itself requires medical treatment.<\/p>\n\n<p class=\"wp-block-paragraph\">In practical terms, this means that whilst emergency treatment for PONV is initially covered by the health insurance fund, the fund may subsequently reclaim the costs incurred from the patient. In individual cases, these claims for reimbursement can amount to several thousand euros.<\/p>\n\n<p class=\"wp-block-paragraph\">Follow-up costs insurance provides cover against precisely these recovery claims, with cover of up to 300,000 euros.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-2&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-2-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-2\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">What are the typical costs involved in treating PONV?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-2\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-2-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">The treatment of post-operative nausea in the recovery room generally involves manageable costs for anti-emetics and medical care. The situation becomes critical if PONV leads to a prolonged hospital stay or if a complication such as aspiration or wound dehiscence arises as a result of the gag reflex.<\/p>\n\n<p class=\"wp-block-paragraph\">An additional stay in hospital can easily cost between 500 and 1,500 euros a day. In the event of serious complications such as Mendelson\u2019s syndrome (aspiration pneumonia), intensive care treatment can run to substantial five- or six-figure sums.<\/p>\n\n<p class=\"wp-block-paragraph\">In the case of cosmetic procedures, the patient will, in case of doubt, bear these costs themselves, or the health insurance fund will seek reimbursement.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-3&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-3-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-3\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Can PONV be prevented so reliably that protection is unnecessary?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-3\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-3-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Even with optimal prophylaxis, PONV cannot be completely ruled out. Even with consistent dual prophylaxis and the avoidance of risk factors, post-operative nausea occurs in some patients, particularly those with a high Apple score.<\/p>\n\n<p class=\"wp-block-paragraph\">Furthermore, not all operations are suitable for regional anaesthesia. In the case of major cosmetic procedures such as a tummy tuck or breast augmentation, general anaesthesia is often unavoidable, which inherently increases the risk of PONV.<\/p>\n\n<p class=\"wp-block-paragraph\">The remaining residual risk may have financial consequences, which are covered by follow-up cost insurance as a preventative measure.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-4&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-4-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-4\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">At what point does it make sense to take out insurance to cover follow-up costs for planned cosmetic surgery?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-4\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-4-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">As a general rule, the more extensive the procedure under general anaesthesia and the greater the number of Apple Score risk factors present, the more important it is to have financial protection. Procedures such as liposuction, tummy tucks, breast augmentation or rhinoplasty are routinely carried out under general anaesthesia and are among those associated with an increased risk of PONV.<\/p>\n\n<p class=\"wp-block-paragraph\">You can take out follow-up costs insurance with 4beauty up to 24 hours before the procedure, even if the date of the operation has already been set.<\/p>\n\n<p class=\"wp-block-paragraph\">Insurance cover from 35 euros a year.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-5&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-5-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-5\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Is post-operative nausea covered as a complication under follow-on costs insurance?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-5\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-5-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">PONV itself is primarily a side effect associated with anaesthesia. It becomes relevant to insurance matters when it leads to a complication requiring treatment: for example, aspiration pneumonia, wound dehiscence caused by the gag reflex, dehydration requiring hospitalisation, or if the health insurance provider recovers the costs of emergency treatment incurred in connection with the insured procedure.<\/p>\n\n<p class=\"wp-block-paragraph\">4beauty\u2019s follow-up costs insurance covers medically necessary treatments and protects against claims for reimbursement from health insurance providers, up to a sum insured of 300,000 euros.<\/p>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Furthermore, the typical patient planning cosmetic surgery is, statistically speaking, female; as such, she already presents the strongest single risk factor in the Apfel score. Combined with non-smoking status and the post-operative administration of opioids for pain management, this quickly results in a moderate to high risk of PONV.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"was-bedeutet-das-konkret-fur-die-planung\">What does this mean in practical terms for planning?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Make a point of raising the subject of PONV during your pre-operative consultation with your anaesthetist. Ask about targeted prophylaxis and whether TIVA (total intravenous anaesthesia) is an option for your procedure. Inform the medical team of any previous experiences of nausea following anaesthesia or of any known susceptibility to travel sickness.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Should PONV nevertheless occur and result in follow-up treatment, you will be faced with the question of who bears the costs if you have had cosmetic surgery paid for privately. Statutory health insurance funds do not cover these costs for cosmetic procedures, or only do so under very strict conditions. 4beauty\u2019s follow-up costs insurance offers transparent cover in such cases and can be taken out up to 24 hours before the procedure. You can find out more about this in the frequently asked questions.<\/p>\n\n\n\n<div class=\"wp-block-group is-style-boxed is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\">With 4beauty\u2019s follow-up treatment insurance, medically necessary follow-up treatment is covered, even if PONV or other complications arise unexpectedly.<\/p>\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-polar\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/4beauty.de\/en\/after-care-insurance\/\">Insure against consequential costs<\/a><\/div>\n<\/div>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"haufig-gestellte-fragen-zu-postoperativer-ubelkeit\">Frequently asked questions about post-operative nausea<\/h2>\n\n\n\n<div data-wp-context=\"{ &quot;autoclose&quot;: false, &quot;accordionItems&quot;: [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-6&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-6-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-6\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">What is PONV, and what does the abbreviation stand for?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-6\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-6-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">PONV stands for <strong>Post-operative Nausea and Vomiting<\/strong>, in German: postoperative nausea and vomiting. This refers to nausea, retching or vomiting that occurs within the first 24 hours following a surgical procedure under general anaesthesia. In German-speaking countries, the abbreviation P\u00dcWE (postoperative nausea and retching\/vomiting) is also occasionally used. PONV is considered one of the most common complications following general anaesthesia.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-7&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-7-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-7\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">How long does post-operative nausea last?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-7\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-7-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Post-operative nausea usually subsides within 6 to 24 hours after surgery in most patients. In rare cases, particularly in high-risk patients or following procedures involving prolonged anaesthesia, symptoms may persist for up to 72 hours. If vomiting persists for longer than this or occurs more than three times within 24 hours, medical advice should be sought to rule out dehydration or other complications.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-8&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-8-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-8\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">As a woman, am I more prone to post-operative nausea?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-8\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-8-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Yes. According to the Apfel Score, female gender is considered one of the four established major risk factors for PONV. Statistically, women have a risk that is approximately two to three times higher than that of men. This difference is hormone-related and can be effectively reduced through targeted prophylaxis, for example with ondansetron or dexamethasone. You should therefore always inform the anaesthesia team of your medical history.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-9&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-9-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-9\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Which type of anaesthesia causes less post-operative nausea?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-9\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-9-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">The <strong>TIVA (Total Intravenous Anaesthesia)<\/strong> General anaesthesia using propofol as the active ingredient is considered to be the form of general anaesthesia with the lowest incidence of PONV. Propofol itself has mild antiemetic properties and does not contain any inhalation anaesthetics, which are among the strongest triggers of PONV. Avoiding nitrous oxide also significantly reduces the risk. If you are at increased risk of PONV, you can specifically ask your doctor about TIVA as an alternative.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-10&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-10-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-10\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Does the health insurance cover any follow-up costs arising from PONV?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-10\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-10-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">In the case of cosmetic procedures paid for privately, statutory health insurance funds do not usually cover any resulting follow-up treatment, or only cover a proportion of the costs. If complications arising from PONV result in additional treatment \u2013 such as a prolonged stay in the recovery room, an unplanned hospital admission or follow-up medication \u2013 these costs often have to be borne by the patient themselves. Follow-up costs insurance for cosmetic procedures can provide targeted cover in such cases and covers medically necessary follow-up treatment.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-11&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-11-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-11\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Is post-operative nausea dangerous?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-11\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-11-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">In most cases, PONV is unpleasant but not dangerous. The most serious complication is the aspiration of stomach contents into the airways, which can cause chemical pneumonia (Mendelson\u2019s syndrome); this risk is particularly high immediately after anaesthesia. Severe retching can also put strain on fresh surgical sutures. Persistent nausea and vomiting can lead to dehydration. It is therefore important to implement targeted preventative measures and, if necessary, provide prompt treatment in the recovery room.<\/p>\n<\/div>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Post-operative nausea and vomiting (PONV) occurs within the first 24 hours following surgery under general anaesthesia and affects around 30 % of all patients.<\/p>","protected":false},"template":"","class_list":["post-728","glossary","type-glossary","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/4beauty.de\/en\/wp-json\/wp\/v2\/glossary\/728","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/4beauty.de\/en\/wp-json\/wp\/v2\/glossary"}],"about":[{"href":"https:\/\/4beauty.de\/en\/wp-json\/wp\/v2\/types\/glossary"}],"wp:attachment":[{"href":"https:\/\/4beauty.de\/en\/wp-json\/wp\/v2\/media?parent=728"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}