Operating Room Noise Environment and Behavior in Children Undergoing General Anesthesia: A Randomized Controlled
Marc Bozych1, Nguyen K Tram1, Julie Rice-Weimer1
1Department of Anesthesiology & Pain Medicine Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Reducing operating room noise positively impacts children's behavior after surgery. A low-stimulus environment improved post-discharge behavior in pediatric patients, though provider response times were unaffected.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Patient Safety
Background:
- Excessive operating room noise can disrupt communication, monitoring, and increase patient and provider stress.
- Perioperative noise levels are a concern in pediatric anesthesia.
- Understanding noise impact is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the impact of reduced operating room noise on pediatric patients' behavior during general anesthesia.
- To assess the effect of a low-stimulus environment on anesthesia provider response times.
- To evaluate secondary outcomes including postoperative pain and noise exposure levels.
Main Methods:
- Randomized controlled trial involving 64 children (2-8 years) undergoing general anesthesia.
- Intervention group received reduced stimulation during induction and emergence.
- Primary outcomes: patient behavior and provider response time. Secondary outcomes: pain scores, prolonged provider responses, and noise levels.
Main Results:
- Children in the reduced noise group showed significantly improved post-discharge behavior, including less fussiness and fewer temper tantrums.
- No significant differences were observed in provider response times or postoperative pain scores between groups.
- Noise exposure levels remained within national safety guidelines for both groups.
Conclusions:
- A low-stimulus environment in the operating room can lead to better post-discharge behavior in children.
- Reducing perioperative noise does not appear to affect anesthesia provider response times.
- This study provides evidence for the benefits of noise reduction strategies in pediatric surgical settings.
Background:
Excessive operating room noise impairs communication, distracts from monitoring equipment, and may increase patient and provider stress.
Aim:
This study investigates the effects of reduced noise on perioperative behavior in children undergoing general anesthesia and on anesthesia provider response time.
Methods:
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.
Results:
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" (p=0.042), more "interested in what goes on around them" (p=0.008), and had fewer temper tantrums (p=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.
Conclusions:
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.
