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A Randomized Controlled Trial of Ergonomic Risk in Pediatric Adenotonsillectomy
David Barkyoumb1, Zainab Sandhu1, Sukaina Hasnie1,2
1Department of Otolaryngology-Head and Neck Surgery, OU College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Summary
Performing adenotonsillectomies while seated significantly reduces ergonomic risk for surgeons compared to standing. This finding suggests optimizing surgeon posture can improve operative safety and comfort during pediatric procedures.
Area of Science:
- Otolaryngology
- Surgical Ergonomics
- Pediatric Surgery
Background:
- Intraoperative ergonomics is crucial for surgeon well-being and patient safety.
- Pediatric otolaryngology procedures like tonsillectomy and adenoidectomy present unique ergonomic challenges.
Purpose of the Study:
- To compare the intraoperative ergonomics of seated versus standing positions for tonsillectomies and adenoidectomies.
- To evaluate ergonomic risk using the Rapid Upper Limb Assessment (RULA) in pediatric otolaryngology residents and attending physicians.
Main Methods:
- A randomized controlled trial was conducted at a tertiary care center.
- Intraoperative data, including RULA scores, were collected for 13 residents and 2 attending physicians.
- Procedures were randomized to either seated or standing positions, with RULA quantifying ergonomic risk on a 0-7 scale.
Main Results:
- The seated position demonstrated significantly lower mean RULA scores (3.26) compared to the standing position (3.76) (P < .001).
- Multivariable analysis confirmed the seated position's ergonomic benefit.
- While PGY1 residents showed the lowest scores and attending physicians the highest in univariate analysis, this was not confirmed multivariably. Specific body region scores varied between positions.
Conclusions:
- Sitting during adenotonsillectomy may mitigate intraoperative ergonomic risk for surgeons.
- Further research is needed to optimize surgical ergonomics in pediatric otolaryngology.
- Findings may inform ergonomic practices for similar intraoral procedures.
