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Background and Aims Postoperative nausea and vomiting (PONV) remain common complications in surgical patients, often necessitating second-line antiemetic intervention in the Post-Anaesthesia Care Unit (PACU). Ondansetron, a 5-HT3 receptor antagonist, is widely used intraoperatively as first-line prophylaxis. However, in current practice, it is frequently repeated in PACU despite limited evidence supporting repeated dosing from the same drug class. Clinical guidelines recommend a multimodal approach, suggesting the use of alternative classes such as antihistamines (e.g., Cyclizine) as more appropriate second-line therapy. Aim: To assess the current practice regarding the second dose of antiemetic administration in PACU—specifically evaluating whether Cyclizine is being used in place of repeated Ondansetron doses, and whether this aligns with evidence-based recommendations.Methods A structured survey was distributed to anaesthesia and PACU staff to collect data on intraoperative antiemetic use, second-line decisions in PACU, and perceived patient outcomes. Data were compared against current clinical guidelines to identify deviations and potential areas for practice improvement.Results 70% of clinicians repeated Ondansetron despite initial administration intraoperatively; only 20% opted for Cyclizine. Most respondents agreed that Cyclizine provided better symptom relief in recovery.Conclusions Preliminary findings suggest a frequent duplication of Ondansetron dosing in PACU, which may not align with current best-practice guidelines advocating for a multimodal strategy. Education and departmental guidelines may help promote rational antiemetic use, reduce drug redundancy, and enhance patient comfort and recovery.