GAMBARAN SKOR APFEL PADA PASIEN SUBARACHNOID BLOCK (SAB) TEKNIK ENHANCED RECOVERY AFTER SURGERY (ERAS) DI RUMAH SAKIT TK. II UDAYANA Ni Made Nopya Darmapatni Fakultas Kesehatan Program Studi D IV Keperawatan Anestesiologi Institut Teknologi dan Kesehatan Bali Email: [email protected] ABSTRAK Latar belakang: salah satu teknik Spinal Anestesi adalah ERAS yang merupakan sebagai penatalaksanaan perioperatif berbasis multimodal. Pada teknik ERAS juga terjadi PONV yang diakibatkan penggunaan golongan opioid sebelum dan sesudah operasi. Untuk memprediksi terjadinya PONV dapat menggunakan Skor Apfel yang merupakan sistem skoring yang objektif dan paling sederhana untuk memprediksi kejadian PONV. Tujuan: Untuk mengidentifikasi gambaran skor apfel pada pasien Subarachnoid Block (SAB) teknik Enhanced Recovery After Surgery (ERAS) Metode: Penelitian ini bersifat deskriptif dengan pendekatan cross-sectional. Sampel dalam penelitian ini adalah pasien yang menjalani tindakan SAB sebanyak 176 responden yang diambil dengan teknik total sampling. Alat pengumpulan data menggunakan kuisioner dan dianalisa secara descriptive statistics. Hasil penelitian: karakteristik umum responden yang paling banyak terlibat dalam penelitian ini adalah perempuan sebanyak 95 responden (54,0%). Usia berada di rentang 17-25 tahun yaitu 46 (26,1%), pendidikan SMA yaitu 141 (80,1%) dan pekerjaan IRT yaitu 39 (22,2%). tidak memiliki kebiasaan merokok 140 (77,4%). tidak memiliki riwayat PONV/mabuk perjalanan 141 (78,7%). menggunakan opioid pasca operasi 96 (56,0%). skor apfel 0 berjumlah 9 (5,1%), skor apfel 1 berjumlah 45 (25,6%), skor apfel 2 berjumlah 57 (32,4%), skor apfel 3 berjumlah 45 (25,6%), skor apfel 4 berjumlah 20 (11,4%). Kesimpulan: resiko tertinggi terjadinya PONV pada pasien SAB Teknik ERAS ada pada skor 2. Kata Kunci : Skor Apfel, Post Operative Nausea and Vomiting, Subarachnoid block, Enhanced Recovery After Surgery.

THE APFEL SCORE IN PATIENTS WITH SUBARACHNOID BLOCK (SAB) USING THE ENHANCED RECOVERY AFTER SURGERY (ERAS) TECHNIQUE AT TK. II UDAYANA HOSPITAL Ni Made Nopya Darmapatni Faculty of Health Diploma IV Nursing Anesthesiology Institute of Technology and Health Bali Email: [email protected] ABSTRACT Background. One of the spinal anesthesia techniques is ERAS, multimodal-based perioperative management. In the ERAS technique, PONV may also occur due to the use of opioids before and after surgery. To predict the occurrence of PONV the Apfel Score was used as an objective and simplest scoring system for predicting the occurrence of PONV. The purpose of this study was to identify the Apfel score in patients with subarachnoid block (SAB) using the enhanced recovery after surgery (ERAS) technique at Tk. II Udayana Hospital. Method. This study employed a descriptive study with a cross-sectional approach. The sample in this study was 176 respondents who underwent SAB, recruited through the total sampling technique. Data were collected using a questionnaire and analyzed using descriptive statistics. Results. Findings indicated that from the general characteristics, most of the respondents were women; 95 respondents (54.0%). The age was in the range of 17-25 years, with 46 respondents (26.1%), in the high school education level, with 141 respondents (80.1%), and most were housewives, with 39 respondents (22.2%). Moreover, most of the respondents did not have smoking habits; 140 respondents (77.4%), Did not have a history of PONV/motion sickness; 141 respondents (78.7%), and used postoperative opioids; 96 respondents (56.0%). Furthermore, the Apfel score 0 was in 9 respondents (5.1%), score 1 was in 45 respondents (25.6%), score 2 was in 57 respondents (32.4%), score 3 was in 45 respondents (25.6%), and score 4 was in 20 respondents (11.4%). Conclusion. The highest risk of PONV in SAB ERAS patients is at score 2. Keywords: Apfel Score, Postoperative Nausea and Vomiting, Subarachnoid Block, Enhanced Recovery After Surgery.