Introduction Postoperative nausea and vomiting (PONV) represent a major source of postoperative distress, affecting 40–60% of surgical patients and contributing to serious complications including aspiration pneumonia, wound dehiscence, and prolonged hospitalization.1 Female gender, recognized as an independent risk factor of PONV,2,3 synergizing with surgical characteristics and perioperative psychological stressors such as preoperative anxiety and sleep disturbances,4–6 are to aggravate the...