Effect of noise on auditory processing in the operating room.

BACKGROUND Effective communication is a critical component of patient care in the operative room (OR). However, the presence of loud equipment, a large number of staff members, and music can contribute to high levels of background noise. In a setting in which crucial tasks are performed continuously, distractions and barriers to communication can result in harm to both patients and OR personnel. The purpose of this investigation was to simulate OR listening conditions and evaluate the effect of operating noise on auditory function. STUDY DESIGN This is a prospective investigation of 15 subjects ranging from 1 to 30 years of operative experience. All surgeons had normal peripheral hearing sensitivity. The surgeons' ability to understand and repeat words were tested using the Speech in Noise Test-Revised in 4 different conditions chosen to simulate typical OR environments. These included quiet, filtered noise through a mask and background noise both with and without music. They were tested in both a tasked and in an untasked situation. RESULTS It was found that the impact of noise is considerably greater when the participant is tasked. Surgeons demonstrated substantially poorer auditory performance in music than in quiet or OR noise. Performance in both conditions was poorer when the sentences were low in predictability. CONCLUSIONS Operating room noise can cause a decrease in auditory processing function, particularly in the presence of music. This becomes even more difficult when the communication involves conversations that carry critical information that is unpredictable. To avoid possible miscommunication in the OR, attempts should be made to reduce ambient noise levels.