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术中噪声测量对手术医生应激和患者预后的影响。一项前瞻性、对照、单中心临床试验,纳入 664 例患者。

Impact of intraoperative noise measurement on the surgeon stress and patient outcomes. A prospective, controlled, single-center clinical trial with 664 patients.

机构信息

Department of General, Visceral, Endocrine, and Transplant Surgery, Kantonsspital St. Gallen, Switzerland.

Department of General, Visceral, Endocrine, and Transplant Surgery, Kantonsspital St. Gallen, Switzerland.

出版信息

Surgery. 2020 May;167(5):843-851. doi: 10.1016/j.surg.2019.12.010. Epub 2020 Feb 25.

Abstract

BACKGROUND

The impact of sound-activated noise meters to decrease the noise level in the operating room is not clear. The aim of this study was to determine whether a sound-activated, visual noise meter would decrease noise levels, decrease postoperative morbidity, and improve surgeons' feelings of well-being.

METHODS

This prospective, single-center study proceeded in 2 phases. First, sound levels were compared during a 6-month period with noise measurement only and without a visual feedback function. Second, we conducted a subsequent 6-month phase with noise meters providing direct feedback. Surgeon disturbance during the operation was assessed by a questionnaire after each procedure.

RESULTS

Of the 664 procedures included in this analysis, 447 (67.3%) were in phase 1 and 217 (32.7%) in phase 2. The noise levels in the operating room were decreased by 3.8 dB(A) from 54.6 ± 4.5 dB(A) in phase 1 to 50.8 ± 2.8 dB(A) in phase 2 after intervention with the feedback device (P < .001). During the procedures, there was an increase of 0.7 dB(A) (P < .001), with mean noise levels of 53.5 dB(A) at the beginning of the procedures and 54.2 dB(A) at the end. There was a correlation between the disturbance of the surgeon and the noise level (P < .001).

CONCLUSION

The application of a visual noise warning device in an operating room decreased both the noise levels and surgeon stress and may offer sustained decreases in ambient and peak sound levels, potentially leading to improved quality outcomes in visceral surgery.

摘要

背景

声音激活噪声计降低手术室噪声水平的效果尚不清楚。本研究旨在确定声音激活、视觉噪声计是否可以降低噪声水平、降低术后发病率并改善外科医生的舒适度。

方法

这是一项前瞻性、单中心研究,分两个阶段进行。首先,在没有视觉反馈功能的情况下,仅进行噪声测量,比较了 6 个月期间的噪声水平。其次,我们进行了随后的 6 个月阶段,使用提供直接反馈的噪声计。每次手术后,通过问卷评估手术过程中外科医生的干扰情况。

结果

在本分析中包含的 664 例手术中,447 例(67.3%)在第 1 阶段,217 例(32.7%)在第 2 阶段。与干预前相比,使用反馈设备后手术室噪声水平从第 1 阶段的 54.6±4.5dB(A)降低至第 2 阶段的 50.8±2.8dB(A),降低了 3.8dB(A)(P<0.001)。在手术过程中,噪声水平增加了 0.7dB(A)(P<0.001),手术开始时的平均噪声水平为 53.5dB(A),手术结束时为 54.2dB(A)。外科医生的干扰与噪声水平之间存在相关性(P<0.001)。

结论

在手术室中应用视觉噪声警告装置可降低噪声水平和外科医生的压力,并可能持续降低环境和峰值噪声水平,从而潜在改善内脏手术的质量结果。

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