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耳鼻喉头颈外科手术室的噪声:系统评价。

Noise in Otolaryngology - Head and Neck Surgery operating rooms: a systematic review.

机构信息

Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Department of Otolaryngology Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.

出版信息

J Otolaryngol Head Neck Surg. 2021 Feb 11;50(1):8. doi: 10.1186/s40463-020-00487-6.

Abstract

OBJECTIVE

Noise in operating rooms (OR) can have negative effects on both patients and surgical care workers. Noise can also impact surgical performance, team communication, and patient outcomes. Such implications of noise have been studied in orthopedics, neurosurgery, and urology. High noise levels have also been demonstrated in Otolaryngology-Head and Neck Surgery (OHNS) procedures. Despite this, no previous study has amalgamated the data on noise across all OHNS ORs to determine how much noise is present during OHNS surgeries. This study aims to review all the literature on noise associated with OHNS ORs and procedures.

METHODS

Ovid Medline, EMBASE Classic, Pubmed, SCOPUS and Cochrane databases were searched following PRISMA guidelines. Data was collected on noise measurement location and surgery type. Descriptive results and statistical analysis were completed using Stata.

RESULTS

This search identified 2914 articles. Final inclusion consisted of 22 studies. The majority of articles analyzed noise level exposures during mastoid surgery (18/22, 82%). The maximum noise level across all OHNS ORs and OHNS cadaver studies were 95.5 a-weighted decibels (dBA) and 106.6 c-weighted decibels (dBC), respectively (P = 0.2068). The mean noise level across all studies was significantly higher in OHNS cadaver labs (96.9 dBA) compared to OHNS ORs (70.1 dBA) (P = 0.0038). When analyzed together, the mean noise levels were 84.9 dBA.

CONCLUSIONS

This systematic review demonstrates that noise exposure in OHNS surgery exceeds safety thresholds. Further research is needed to understand how noise may affect team communication, surgical performance and patient outcomes in OHNS ORs.

摘要

目的

手术室(OR)中的噪音可能对患者和外科医护人员都产生负面影响。噪音还会影响手术表现、团队沟通和患者预后。此类噪音的影响已经在骨科、神经外科和泌尿科进行了研究。耳鼻喉头颈外科(OHNS)手术中也已经证实存在高噪声水平。尽管如此,以前没有研究综合所有 OHNS OR 中关于噪声的数据,以确定 OHNS 手术过程中存在多少噪声。本研究旨在回顾所有与 OHNS OR 和手术相关的噪声文献。

方法

根据 PRISMA 指南,在 Ovid Medline、EMBASE Classic、Pubmed、SCOPUS 和 Cochrane 数据库中进行搜索。收集噪声测量位置和手术类型的数据。使用 Stata 完成描述性结果和统计分析。

结果

本次搜索共确定了 2914 篇文章。最终纳入了 22 项研究。大多数文章分析了乳突手术期间的噪声水平暴露(18/22,82%)。所有 OHNS OR 和 OHNS 尸体研究中最大噪声水平分别为 95.5 加权分贝(dBA)和 106.6 加权分贝(dBC)(P=0.2068)。所有研究中,OHNS 尸体实验室的平均噪声水平明显高于 OHNS OR(96.9 dBA 比 70.1 dBA)(P=0.0038)。一起分析时,平均噪声水平为 84.9 dBA。

结论

本系统评价表明,OHNS 手术中的噪声暴露超过了安全阈值。需要进一步研究以了解噪声如何影响 OHNS OR 中的团队沟通、手术表现和患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da83/7879658/b2baed6bdd28/40463_2020_487_Fig1_HTML.jpg

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