{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:41:54Z","timestamp":1789177314759,"version":"build-2803163510"},"reference-count":69,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"St. George\u2019s University, Grenada Medical Student Research Institute"},{"id":[{"id":"https:\/\/ror.org\/01m1s6313","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Postoperative nausea and vomiting (PONV) remain a leading preventable perioperative complication despite advances in anesthetic and surgical care, significantly affecting recovery within Enhanced Recovery After Surgery (ERAS) pathways. ERAS protocols provide a structured, multidisciplinary framework for perioperative optimization; however, variability in the implementation of PONV prevention strategies persists. This narrative review synthesizes current evidence on perioperative strategies for PONV prevention within ERAS pathways, focusing on patient risk stratification, multimodal pharmacologic prophylaxis, anesthetic techniques, and adjunctive non-pharmacologic interventions. We evaluate validated risk prediction tools, including the Apfel score, and highlight the importance of individualized prophylactic strategies based on patient, surgical, and anesthetic risk factors. Multimodal antiemetic regimens, opioid-sparing anesthesia, total intravenous anesthesia (TIVA), and regional techniques are discussed as key components of perioperative management. In addition, non-pharmacologic interventions such as optimized fluid therapy, early mobilization, and supportive perioperative care are reviewed as integral elements of ERAS-based recovery pathways. Complementing existing consensus guidelines, this review provides a practical, workflow-based framework spanning preoperative risk assessment, intraoperative decision-making, and postoperative monitoring for direct application within ERAS protocols.<\/jats:p>","DOI":"10.3390\/jcm15103829","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T12:36:40Z","timestamp":1779107800000},"page":"3829","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Perioperative Anesthesia Strategies for the Prevention of Postoperative Nausea and Vomiting Within Enhanced Recovery After Surgery Pathways: A Clinical Narrative Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4785-0733","authenticated-orcid":false,"given":"Rachel","family":"Dombrower","sequence":"first","affiliation":[{"name":"School of Medicine, St. George\u2019s University, West Indies 11739, Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3461-9335","authenticated-orcid":false,"given":"Alyssa","family":"McKenzie","sequence":"additional","affiliation":[{"name":"School of Medicine, St. George\u2019s University, West Indies 11739, Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnathan","family":"Atwell","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, Nova Southeastern University, Fort Lauderdale, FL 33328, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1111\/aas.13936","article-title":"Early post-operative nausea and vomiting: A retrospective observational study of 2030 patients","volume":"65","author":"Johansson","year":"2021","journal-title":"Acta Anaesthesiol. 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