Bozych Marc, Tram Nguyen K, Rice-Weimer Julie, Cartabuke Richard S, Tobias Joseph D, Huffman Jamie, Mpody Christian, Uffman Joshua C
Department of Anesthesiology & Pain Medicine Nationwide Children's Hospital, Columbus, OH, USA.
Department of Anesthesiology & Pain Medicine The Ohio State University, Columbus, OH, USA.
Anesthesiol Res Pract. 2024 Aug 16;2024:4838649. doi: 10.1155/2024/4838649. eCollection 2024.
Excessive operating room noise impairs communication, distracts from monitoring equipment, and may increase patient and provider stress.
This study investigates the effects of reduced noise on perioperative behavior in children undergoing general anesthesia and on anesthesia provider response time.
Healthy children (the American Society of Anesthesiologists class I-II), 2-8 years of age, and their anesthesia providers were randomized into a control or treatment group exposed to reduced stimulation during induction and emergence. Primary outcomes were patient behavior and provider response time. Secondary outcomes were postoperative pain scores, provider responses exceeding 30 seconds, and median and maximum noise exposure.
64 children (27 females and 37 males) were randomized into a control or treatment group, of whom 32 (50%) underwent tonsillectomy/adenoidectomy and 32 (50%) underwent dental procedures. The average age was 4.6 (SD 1.43) years. Children exposed to reduced noise were less likely to be "fussy about eating" (=0.042), more "interested in what goes on around them" (=0.008), and had fewer temper tantrums (=0.004) on postoperative day one or two and on postoperative day five, six, or seven. No other differences were found between groups in behavioral assessment scores or provider response times.
Our study is the first to show that a low-stimulus environment improves postdischarge behavior. Provider response time was unaffected by reduced noise, and the average and peak noise exposure levels did not exceed national safety guidelines. This trial is registered with NCT03507855 and NCT03504553.
手术室噪音过大妨碍沟通，干扰监测设备，可能增加患者和医护人员的压力。
本研究调查降低噪音对接受全身麻醉儿童围手术期行为及麻醉医护人员反应时间的影响。
将2至8岁的健康儿童（美国麻醉医师协会分级为I-II级）及其麻醉医护人员随机分为对照组或治疗组，在诱导和苏醒期间给予减少刺激的环境。主要结局指标为患者行为和医护人员反应时间。次要结局指标为术后疼痛评分、反应时间超过30秒的医护人员反应情况、平均和最大噪音暴露水平。
64名儿童（27名女性和37名男性）被随机分为对照组或治疗组，其中32名（50%）接受扁桃体切除术/腺样体切除术，32名（50%）接受牙科手术。平均年龄为4.6（标准差1.43）岁。在术后第1天或第2天以及术后第5、6或7天，暴露于较低噪音环境的儿童“对进食挑剔”的可能性较小（P=0.042），对“周围发生的事情更感兴趣”（P=0.008），发脾气的次数更少（P=0.004）。两组在行为评估评分或医护人员反应时间方面未发现其他差异。
我们的研究首次表明，低刺激环境可改善出院后的行为。噪音降低对医护人员反应时间无影响，平均和峰值噪音暴露水平未超过国家安全指南。本试验已在ClinicalTrials.gov上注册，注册号为NCT03507855和NCT03504553。
