Each study patient will receive Palonosetron alone or Palonosetron plus Dexamethasone immediately prior to the start of her/his surgery. We will then use an 11 point nausea scale to determine how many patients had a complete response to the medication (complete response = NO nausea and NO vomiting at any time during the study period of 0-72 hours post surgery). If a patient does experience nausea or vomiting, we will record the time and severity of the PONV as well as whether any medication was given to relieve the nausea and vomiting. If a patient is discharged from the hospital before their 72nd hour post surgery, (s)he will receive a journal in which to record any symptoms or nausea or vomiting and a member of the research team will call to obtain the information.