Patient description: The patient is a 20 year old Caucasian female presents to the clinic with one-sided vision lost and facial weakness, dysarthria and numbness lasting for 1 day. She visited her PCP and underwent brain MRI which revealed a single plaque in the brainstem. After few months, she experienced lower extremities weakness led to balance problem. The second MRI revealed another lesion in the left cerebral hemisphere. The diagnosis of Relapsing Remitting Multiple Sclerosis (RRMS) is confirmed after the second MRI. Her past surgical history is significant for a C-section 2 years ago and she has a one child. She is divorced and is not currently in any sexual relationship. She smokes 10 cigarettes per day and drinks alcohol occasionally. She is working as an editor in a publisher company and she is happy that she can keep working from home most of the time. She is under the treatment of RRMS from 7 months ago.

Clinical trial eligibility criteria: eligible ages (years): 18.0-65.0,  Postoperative Nausea and Vomiting All of the following must be met for the potential subject to be eligible for participation: 1. The subject is a female scheduled to undergo ambulatory breast surgery performed under general anesthesia 2. The subject is expected to undergo general inhalation anesthesia. 3. The subject presents with two of the three following high-risk factors associated with PONV (must be in their medical history in order to be eligible) She is a non-smoker She has documented history of PONV and/or motion sickness She is expected to receive intra-operative and postoperative opioid. 4. The subject's American Society of Anesthesiologist physical status is ASA I-III 5. The subject is between18 to 65 years of age. 6. The subject is expected to be discharged from the hospital/surgical center on the same day as the surgery. 7. The subject has provided written informed consent to participate in the study. If any of the following  are met, the potential subject is NOT eligible for participation: 1. The subject has a history of allergic reaction to, intolerances of or contraindications for any of the study medications or required anesthetic agents. 2. The subject has received or is expected to receive any excluded preoperative drug within 48 hours prior to induction; or is expected to receive any excluded intra-operative or postoperative medications. 3. The subject is pregnant or lactating. (If the potential subject is pre-menopausal, a urine pregnancy test must be performed within 24 hours/1 day of study prior to the planned surgery time and confirmed negative in order for the potential subject to be enrolled). 4. The subject is taking warfarin. 5. The subject has a history of alcohol and/or drug abuse within 1 year of study medication, or has a positive screening or pre-study test for alcohol or drugs of abuse. 6. The subject is expected to require the use of a nasogastric tube postoperatively. 7. The subject has a diagnosed latex allergy. 8. The subject has used oral aprepitant (Emend®) within the last 30 days. 9. The subject has participated in a randomized study or has been exposed to any experimental drug within 30 days prior to enrollment of this study