Case-Type Variation in Orthopedic Surgery Noise Levels

Abstract/Description/Artist Statement

Introduction

Noise levels in the orthopedic operating room (OR) commonly exceed occupational recommendations, yet their effects on OR team communication, performance, and distractibility are not well defined. This study’s primary aim was to compare intraoperative noise levels across orthopedic case types and evaluate relationships between noise exposure and staff-perceived performance.

Methods

This study utilized a prospective cross-sectional design. Orthopedic cases at a single institution were identified in Medical Health System Genesis and categorized as arthroplasty, arthroscopy, minor hand–local, bony work, or soft tissue work. Intraoperative noise was recorded using the NIOSH smartphone app, capturing time-weighted average (TWA), maximum decibel level (MDL), peak level (LCpeak), equivalent sound level (LAeq). After each case, the attending surgeon, primary resident, anesthesia provider, circulating nurse, and scrub nurse/technician completed Likert-scale surveys assessing communication, individual performance, and distractibility.

Results

Fifty-one cases and 255 survey responses were analyzed. LAeq differed by case type, with minor hand–local cases being quietest (56.9 dB) and arthroplasty being loudest (85.4 dB). Noise metrics correlated with case duration included maximum level (r=0.38) and LCpeak (r=0.32). Survey responses were strongly correlated with each other (r = 0.75–0.95). Music was perceived to positively influence OR atmosphere. ANOVA analysis showed significant differences between case types for duration, LAeq, maximum level, and LCpeak, but not for survey responses.

Conclusion

Orthopedic OR noise levels vary by case type and commonly exceed recommendations. However, noise levels did not have a significant impact on staff perceived communication, performance, or distractibility. Noise mitigation strategies remain encouraged.

Presenting Author Name/s

Emilio Ihde

Faculty Advisor/Mentor

Dr. Andrew Henebry

Faculty Advisor/Mentor Email

andrew.d.henebry.mil@health.mil

Faculty Advisor/Mentor Department

NMCP Department of Orthopedic Surgery

College/School Affiliation

Eastern Virginia School of Medicine

Student Level Group

Medical

Presentation Type

Poster

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Case-Type Variation in Orthopedic Surgery Noise Levels

Introduction

Noise levels in the orthopedic operating room (OR) commonly exceed occupational recommendations, yet their effects on OR team communication, performance, and distractibility are not well defined. This study’s primary aim was to compare intraoperative noise levels across orthopedic case types and evaluate relationships between noise exposure and staff-perceived performance.

Methods

This study utilized a prospective cross-sectional design. Orthopedic cases at a single institution were identified in Medical Health System Genesis and categorized as arthroplasty, arthroscopy, minor hand–local, bony work, or soft tissue work. Intraoperative noise was recorded using the NIOSH smartphone app, capturing time-weighted average (TWA), maximum decibel level (MDL), peak level (LCpeak), equivalent sound level (LAeq). After each case, the attending surgeon, primary resident, anesthesia provider, circulating nurse, and scrub nurse/technician completed Likert-scale surveys assessing communication, individual performance, and distractibility.

Results

Fifty-one cases and 255 survey responses were analyzed. LAeq differed by case type, with minor hand–local cases being quietest (56.9 dB) and arthroplasty being loudest (85.4 dB). Noise metrics correlated with case duration included maximum level (r=0.38) and LCpeak (r=0.32). Survey responses were strongly correlated with each other (r = 0.75–0.95). Music was perceived to positively influence OR atmosphere. ANOVA analysis showed significant differences between case types for duration, LAeq, maximum level, and LCpeak, but not for survey responses.

Conclusion

Orthopedic OR noise levels vary by case type and commonly exceed recommendations. However, noise levels did not have a significant impact on staff perceived communication, performance, or distractibility. Noise mitigation strategies remain encouraged.