BACKGROUND: The purpose of this study was to compare the incidence of postoperative nausea and vomiting (PONV) in patients undergoing major gynecologic surgery with those undergoing Cesarean-section during intravenous patient-controlled analgesia (PCA). METHODS: Seventy two patients received general anesthesia with enflurane. Group 1 patients underwent major gynecologic surgery, and group 2 patients were parturients who underwent Cesarean-section. Postoperatively, fentanyl was continuously infused i.v. using Accufuser PLUS (basal, 2 ml/h; bolus, 0.5 ml; lockout interval, 15 min) containing fentanyl 25microgram/kg in saline. PONV was evaluated at 6, 12, 24 and 36 h after starting continuous infusion and compared in the two groups. RESULTS: The incidence of PONV was significantly lower in group 2 (14%) than in group 1 (67%) (P < 5). CONCLUSIONS: Our results show that the incidence of PONV was lower for Cesarean-section than for gynecologic surgery.