Efficacy of Adding Oral Amisulpride to Dual Prophylaxis for Postoperative Nausea and Vomiting in Patients at High Risk for Nausea and Vomiting Undergoing Gynecological Surgery

Exclusion Criteria

• •Cognitive or psychiatric conditions impairing consent or compliance.
• •Incapability of using the mobile app MyCapp for data collection.
• •History of allergy or sensibility to any medication included in the protocol: amisulpride, dexamethasone, ondansetron, fentanyl, midazolam, bupivacaine, morphine, propofol, rocuronium, sevoflurane, ephedrine, metaraminol, remifentanil, metamizole, ketoprofen, sugammadex, dimenhydrinate, pyridoxine hydrochloride, tramadol, dimethicone.
• •Inability to swallow medications.
• •Current use of typical or atypical antipsychotic medications.
• •Gestation or lactation.
• •Clinically significant cardiac arrhythmia or long QT syndrome documented.
• •Hypokalemia (K+ \< 3.5 mmol/L)
• •Prolactin-dependent tumors.
• •Pheochromocytoma.
• •Parkinson's disease.
• •Nausea or vomiting in the 24 hours before surgery.
• •Therapeutic use of antiemetics, including corticosteroids.
• •Emetogenic oncological therapy (above 10% probability of causing vomiting) in the 2 weeks before surgery.
• •Persistent pre-operative hypotension on the day of surgery, defined as systolic blood pressure \< 100 mmHg on at least 2 consecutive measurements.
• •Mechanical ventilation plan or need for a naso/orogastric tube after surgery.
• •Intestinal endometriosis