Reduced noise in the operating room can improve children's postoperative behavior

Reduced noise in the operating room can improve children's postoperative behavior

Reducing noise levels in the operating room (OR) can have positive effects on a child's behavior, including fewer tantrums and a greater willingness to eat, in the days following surgery and anesthesia. according to research presented at the ANESTHESIOLOGY® 2022 annual meeting.

Excessive noise in the operating room is a common complaint among patients and providers, particularly during induction and emergence from general anesthesia. High noise levels can distress patients, increase their anxiety and negatively impact patient safety and comfort.

The time before, during and after surgery is a particularly unpredictable time for parents. By implementing a few small interventions in the OR, we found that we could significantly improve some of these insecurities for parents in the key behavioral areas of mood, eating and engagement.

Nguyen Tram, Ph.D., lead author of the study and research scientist at Nationwide Children's Hospital, Columbus, Ohio

In the study, 64 preschool children (ages 4 to 5 years) undergoing general anesthesia for tonsillectomy/adenoidectomy or dental procedures lasting at least 30 minutes were randomly assigned to either a “reduced noise” group with low ambient lighting, muted communication devices and reduced operating room staff, or a control group (33 in the group with reduced noise vs. 31 in the control group). All patients received a standard oral sedative before induction of anesthesia.

Behavior was assessed using the Induction Compliance Checklist, which measures adverse behavior during induction of anesthesia; Modified Yale Preoperative Anxiety Scale, which assesses children's anxiety during the preoperative period; and Post Hospitalization Behavior Questionnaire, which assesses children's behavioral changes after hospitalization and postoperative recovery. The Post Hospitalization Behavior Questionnaire was completed by parents on postoperative days one and five.

Results from the Post Hospital Behavior Questionnaire found that children in the reduced noise group had fewer tantrums, were less picky about food and were more interested in what was going on around them in the first five days after surgery. In the other analyses, no statistically significant differences were found between the two groups. The researchers believe that a quiet environment can positively influence children's behavior after general anesthesia, similar to how most people need a quiet environment for a good night's sleep.

“We were able to show for the first time how reduced noise in the operating room can improve the postoperative behavior of children in the first few days after general anesthesia,” said Dr. Tram. "Excessive noise not only directly impacts patients, but can potentially compromise patient safety by interfering with provider communication and detection of audible and visual alarms during the critical induction period. Future research is needed to determine the best way to optimize the operating room and perioperative environment to improve patient outcomes after surgery and anesthesia."

Source:

American Society of Anesthesiologists

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