Multimodal PONV Prophylaxis — FRCA Final MCQ

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EasyDay SurgeryMultimodal PONV ProphylaxisFRCA Final

History of severe PONV. Best multimodal antiemetic prophylaxis for day case laparoscopic cholecystectomy?

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Correct answer: A — Dexamethasone 8 mg at induction + ondansetron 4 mg end of surgery

Multimodal with different mechanisms: dexamethasone (glucocorticoid, delayed onset) + ondansetron (5-HT3 antagonist, rapid onset) reduces PONV ~80%. For 3-4 Apfel risk factors, add third agent and TIVA.

Reference: Association of Anaesthetists – 2023 – PONV in day surgery