PONV (Postoperative nausea and vomiting) is one of most common complications after general anesthesia. Female sex, history of PONV, motion sickness, nonsmoker status, use of volatile agents, duration of anesthesia, opioid administration and laparoscopic surgery are known as risk factors for developing PONV. In consequence, patients undergoing laparoscopic gynecologic surgery are at high risk for developing PONV. Most of these patients use fentanyl based IV-PCA. And it also causes PONV.

So, we should prevent PONV in these patients by using multimodal or combination therapy.

Aprepitant is a NK1 receptor antagonist.And it is used to prevent chemotherapy induced nausea and vomiting. Many studies using aprepitant to prevent PONV are in progress.

In this study, we investigate the effect of combining aprepitant with ondansetron in high-risk patients for PONV.

Inclusion Criteria:

• Patient undergoing laparoscopic gynecologic surgery.
• Patient who takes fentanyl based IV PCA
• ASA class I-II

Exclusion Criteria:

• allergy to aprepitant
• take another antiemetics before surgery
• decreased liver function
• psychological disease
• who cannot speak Korean
• take medicines that interacts with emend who do not agree to the study