Laskin DM, et al. - Because the Apfel score is a common predictive measure of postoperative nausea and vomiting (PONV), researchers determined whether it applied to oral and maxillofacial surgery (OMFS) and whether other factors in this population would improve its accuracy. Participants in the study were 167 patients (24% had nausea and 11% had nausea and vomiting) who had OMFS during a 10-month period. In addition to the risk factors of the Apfel score, PONV data were gathered for type of anesthetic induction and maintenance, type of surgery, use of maxillomandibular fixation (MMF), use of opioids, and anesthesia and surgery times. According to this retrospective chart review, patients experiencing orthognathic or temporomandibular joint surgery had the highest PONV rate. In addition, young age, anesthesia and operation time, and use of MMF were linked to increased PONV. Adding age, MMF or limited postoperative opening of the mouth, and type of surgery to the Apfel score should make it more predictive in OMFS.