Ambient Sound Pressure Levels in the Bronchoscopy Suite: Contrasting Flexible, Rigid, and Robotic-Assisted...

Operating room noise can result in provider- and patient-related adverse outcomes. The recommended sound pressure threshold in medical settings is 35-45 dB(A). This study aimed to quantify sound pressure across different types of bronchoscopy procedures.

Sound meters were placed in the bronchoscopy suite. Ambient sound pressure levels were measured continuously during flexible, rigid, and robotic bronchoscopy procedures. Procedures were classified as "quiet" or "loud" using the median equivalent continuous sound pressure level (Leq). A logistic regression model was used to identify associations between the type of bronchoscopy and "loud" or "quiet" procedures.

A total of 186 procedures were analyzed, of which 64% were flexible, 11% were rigid, and 25% were robotic. Across all procedures, the median Leq was 56.8 (55.1 to 58.1) dB(A). Leq was 58.2 (57.5 to 58.9), 59.4 (58.6 to 60.5), and 57.9 (57.5 to 58.4) dB(A) for flexible, rigid, and robotic bronchoscopy, respectively (P<0.0001). In comparison to flexible bronchoscopy, rigid bronchoscopy was more likely to be loud, while robotic bronchoscopy was less likely to be loud.

This is the first study to quantify sound pressure levels during bronchoscopy procedures. Across all types of bronchoscopy procedures, sound pressure levels exceeded those recommended by guidelines for the medical setting and were considered a moderate degree of noise. Rigid bronchoscopy was associated with higher sound pressure levels, whereas robotic-assisted bronchoscopy was associated with lower sound pressure levels when compared with flexible bronchoscopy. Future studies are needed to explore the potential deleterious effects of bronchoscopy noise on operators and patients to inform preventive measures.