Latar Belakang: Post operative nausea and vomiting (PONV) adalah kejadian mual dan muntah yang paling sering terjadi setelah tindakan operasi dengan anestesi pada 24 jam pertama pasca operasi. Penilaian terhadap PONV dapat menggunakan Skor Apfel. Skor Apfel merupakan salah satu prediktor PONV yang objektif dan paling sederhana, skor ini digunakan dalam menilai golongan pasien berdasar atas risiko terhadap PONV yang memiliki kemampuan diskriminasi yang lebih tinggi daripada skor lainnya. Tujuan: Untuk mengetahui kejadian mual muntah pada pasien ambulatory anestesi melalui penilaian Apfel di RSUD Wangaya Metode: Penelitian ini menggunakan deskriptif kualitatif melalui pendekatan studi kasus dengan rancangan multiple case study. Alat pengumpulan data berupa panduan wawancara dengan jumlah partisipan 3 orang. Analisa data menggunakan case analysis dan cross-case analysis. Hasil: Ketiga partisipanmemiliki jenis kelamin perempuan, ketiga partisipan tidak merokok, dua partisipan tidak memiliki riwayat PONV/motion sickness, ketiga partisipan tidak menggunakan opioid post operatif. Sehingga dua partisipan memperoleh skor apfel 2 yaitu risiko rendah dan satu partisipan memperoleh skor apfel 3 yang juga tergolong risiko rendah. Kesimpulan: Penilaian Skor apfel terhadap ketiga partisipan meliputi jenis perempuan, tidak merokok, riwayat PONV/motion sickness, dan opioid post operatif. Kata Kunci: Ambulatory Anestesi, PONV, Skor Apfel

Background. Post Operative Nausea and Vomiting (PONV) is the most common occurrence problem in post-operative with anesthesia in the first 24 hours. The assessment of PONV can use the APFEL Score. The APFEL Score is one of the most objective and simplest predictors of PONV, this score is used to assess patient groups based on the risk to PONV which has higher discriminatory abilities than other scores. Aim. To determine the incidence of nausea and vomiting in ambulatory patients under anesthesia through the assessment of APFEL Score at Wangaya Hospital Method. This study employed qualitative descriptive design with multiple case study. There were 3 participants recruited as the sample. The data were collected using interview guide with and analysed using cross-case analysis. Finding. All three participants were female, did not smoke, did not use post-operative opioids and two participants did not have a history of PONV/motion sickness. So that, two participants obtained APFEL score of 2 which was low risk, and one participant obtained APFEL score of 3 which was also classified as low risk. Conclusion. The assessment of APFEL scores on the three participants included female type, non-smoking, history of PONV/motion sickness, and post-operative opioids. Keywords: Ambulatory Anesthesia, PONV, APFEL Score