手术室噪声对腹腔镜操作性能的影响：一项前瞻性、随机交叉试验。
Impact of Operative Room Noise on Laparoscopic Performance-A Prospective, Randomized Crossover Trial.
机构信息
Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany; Centre for Tactile Internet with Human-in-the-Loop (CeTI), TUD Dresden University of Technology, Dresden, Germany.
出版信息
J Surg Res. 2024 Oct;302:648-655. doi: 10.1016/j.jss.2024.07.110. Epub 2024 Aug 27.
INTRODUCTION
Surgeons are often exposed to different types of operative room (OR) noise, for instance machine alarms, phone calls, and interacting objects. The aim of this study was to evaluate the effect of OR noise on the surgeons' laparoscopic performance.
METHODS
A total of 30 laparoscopic novices participated in this single-center, prospective, randomized cross-over trial after completing a standardized laparoscopic training until reaching proficiency. Afterward, all participants performed four different laparoscopic tasks (peg transfer, circle cutting, balloon resection, suture, and knot) twice, once under noise exposure (intervention group), and once without any noise (control group). Primary endpoints were the force exertion and motion analyses. To assess the psychological workload the NASA task load index score was used.
RESULTS
The error rates varied and were significantly different between the noise and the control group. More complex tasks like the circle cutting and suture and knot task revealed higher error rates concerning precision (circle cutting: P < 0.01; suture and knot: P < 0.01). In line with increased error rates in the circle cutting task, increased NASA task load index scores were observed in this task (P = 0.03). However, no significant differences were found in force parameters, such as the maximal force exertion (peg transfer: P = 0.43; circle cutting: P = 0.54; balloon resection: P = 0.64; suture and knot: P = 0.63) and the mean force exertion (peg transfer: P = 0.43; circle cutting: P = 0.54; balloon resection: P = 0.64; suture and knot: P = 0.63) between the groups.
CONCLUSIONS
Exposure to normal OR noise led to higher error rates in two of four tasks. This effect could be linked to an increased psychological workload that was present under normal OR noise exposure. However, normal OR noise does not appear to impact surgical novices' laparoscopic task performance regarding applied forces and instrument motion.
简介
外科医生经常会接触到不同类型的手术室（OR）噪音，例如机器警报、电话和互动物体。本研究旨在评估 OR 噪音对外科医生腹腔镜操作的影响。
方法
共有 30 名腹腔镜新手在完成标准化腹腔镜培训达到熟练程度后参加了这项单中心、前瞻性、随机交叉试验。之后，所有参与者两次执行四项不同的腹腔镜任务（销转移、圆形切割、球囊切除、缝合和打结），一次在噪声暴露下（干预组），一次在无噪声下（对照组）。主要终点是力的施加和运动分析。为了评估心理工作量，使用了 NASA 任务负荷指数评分。
结果
错误率不同，且在噪声组和对照组之间存在显著差异。更复杂的任务，如圆形切割和缝合打结任务，其精度的错误率更高（圆形切割：P<0.01；缝合打结：P<0.01）。与圆形切割任务中错误率的增加一致，在该任务中观察到 NASA 任务负荷指数评分的增加（P=0.03）。然而，在力参数方面，如最大力施加（销转移：P=0.43；圆形切割：P=0.54；球囊切除：P=0.64；缝合打结：P=0.63）和平均力施加（销转移：P=0.43；圆形切割：P=0.54；球囊切除：P=0.64；缝合打结：P=0.63），两组之间没有发现显著差异。
结论
暴露于正常 OR 噪声会导致四项任务中的两项任务错误率增加。这种影响可能与正常 OR 噪声暴露下存在的心理工作量增加有关。然而，正常 OR 噪声似乎不会影响外科新手的腹腔镜任务性能，包括施加的力和器械运动。
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