Abstract：
Cesarean delivery is the most common major surgery worldwide. Noise in healthcare settings leads to impaired communication and concentration, and stress among healthcare providers. Limited information is available about noise at cesarean delivery.
This study aimed to achieve a comprehensive analysis of noise that occurs during cesarean deliveries. Sound level meters are used to determine baseline noise levels and to describe the frequency of acute noise generated during a cesarean delivery that will cause a human startle response. Secondarily, we aimed to evaluate the effectiveness of a visual alarm system in mitigating excessive noise.
We completed a preintervention/postintervention observational study of noise levels during cesarean deliveries before and after introduction of a visual alarm system for noise mitigation between February 15, 2021 and August 26, 2021. There were 156 cases included from each study period. Sound pressure levels were analyzed by overall case median decibel levels and by time epoch for relevant phases of the operation. Rapid increases in noise events capable of causing a human startle response, \"startle events,\" were detected by retrospective analysis, with quantification for baselines and analysis of frequency by case type. Median noise levels with interquartile ranges are presented. Data are compared between epochs and case characteristics with nonparametric 2-tailed testing.
The median acoustic pressure for all cesarean deliveries was 61.8 (58.8-65.9) (median [interquartile range]) dBA (A-weighted decibels). The median dBA for the full case time period was significantly higher in cases with neonatal intensive care unit team presence (62.1 [60.5-63.9]), admission to the neonatal intensive care unit (62.0 [60.4-63.9]), 5-minute Apgar score <7 (62.2 [61.1-64.3]), multiple gestations (62.6 [62.0-64.2]), and intraoperative tubal sterilization (62.8 [61.5-65.1]). The use of visual alarms was associated with a statistically significant reduction of median noise level by 0.7 dBA, from 61.8 (60.6-63.5) to 61.1 (59.8-63.7) dBA (P<.001).
The noise intensities recorded during cesarean deliveries were commonly at levels that affect communication and concentration, and above the safe levels recommended by the World Health Organization. Although noise was reduced by 0.7 dBA, the reduction was not clinically significant in reaching a discernible amount (a 3-dB change) or in reducing \"startle events.\" Isolated use of visual alarms during cesarean deliveries is unlikely to be a satisfactory noise mitigation strategy.
This study aimed to achieve a comprehensive analysis of noise that occurs during cesarean deliveries. Sound level meters are used to determine baseline noise levels and to describe the frequency of acute noise generated during a cesarean delivery that will cause a human startle response. Secondarily, we aimed to evaluate the effectiveness of a visual alarm system in mitigating excessive noise.
We completed a preintervention/postintervention observational study of noise levels during cesarean deliveries before and after introduction of a visual alarm system for noise mitigation between February 15, 2021 and August 26, 2021. There were 156 cases included from each study period. Sound pressure levels were analyzed by overall case median decibel levels and by time epoch for relevant phases of the operation. Rapid increases in noise events capable of causing a human startle response, \"startle events,\" were detected by retrospective analysis, with quantification for baselines and analysis of frequency by case type. Median noise levels with interquartile ranges are presented. Data are compared between epochs and case characteristics with nonparametric 2-tailed testing.
The median acoustic pressure for all cesarean deliveries was 61.8 (58.8-65.9) (median [interquartile range]) dBA (A-weighted decibels). The median dBA for the full case time period was significantly higher in cases with neonatal intensive care unit team presence (62.1 [60.5-63.9]), admission to the neonatal intensive care unit (62.0 [60.4-63.9]), 5-minute Apgar score <7 (62.2 [61.1-64.3]), multiple gestations (62.6 [62.0-64.2]), and intraoperative tubal sterilization (62.8 [61.5-65.1]). The use of visual alarms was associated with a statistically significant reduction of median noise level by 0.7 dBA, from 61.8 (60.6-63.5) to 61.1 (59.8-63.7) dBA (P<.001).
The noise intensities recorded during cesarean deliveries were commonly at levels that affect communication and concentration, and above the safe levels recommended by the World Health Organization. Although noise was reduced by 0.7 dBA, the reduction was not clinically significant in reaching a discernible amount (a 3-dB change) or in reducing \"startle events.\" Isolated use of visual alarms during cesarean deliveries is unlikely to be a satisfactory noise mitigation strategy.
摘要：
背景：剖宫产是全世界最常见的主要手术。医疗保健环境中的噪音导致沟通受损，浓度,和卫生保健提供者之间的压力。关于剖宫产时噪音的信息有限。
目的：我们的目的是对剖宫产期间发生的噪音进行全面分析。声级计用于确定基线噪声水平，并描述剖腹产期间产生的急性噪声的频率，该噪声将引起人类惊吓反应。其次，我们将评估视觉报警系统减轻过度噪音的有效性。
方法：在2021年2月15日至2021年8月26日期间，我们完成了一项关于剖宫产分娩期间噪声水平的干预前/干预后观察性研究，该研究在引入视觉报警系统以减轻噪声之前和之后。每个研究期间包括156例病例。声压级通过整体病例中位数分贝水平和手术相关阶段的时间周期进行了分析。能够引起人类惊吓反应的快速增加的噪声事件，通过回顾性分析发现了“惊吓事件”，对基线进行量化，并按病例类型进行频率分析。给出了具有四分位数间范围的中值噪声水平[I.Q.R.]。使用非参数双尾检验在时期和案例特征之间比较数据。
结果：所有剖宫产分娩的声压中位数为61.8[58.8,65.9]dBA（中位数[I.Q.R.]）。在NICU团队存在的病例中，整个病例时间段的中位数dBA明显更高，62.1[60.5，63.9]；新生儿入住NICU，62.0[60.4,63.9];5分钟APGAR评分小于7,62.2[61.1,64.3];多胎妊娠,62.6[62.0，64.2]；术中输卵管灭菌，62.8[61.5,65.1]。视觉警报的使用与中位数噪声水平在统计学上显着降低0.7dBA相关，从61.8[60.6,63.5]dBA到61.1[59.8,63.7]dBA，（p<0.001）。
结论：剖宫产期间记录的噪音强度通常在影响沟通和注意力的水平，并且高于W.H.O.建议的安全水平。尽管噪音降低了0.7dBA，该降低对于降低噪音明显(3dB变化)或减少“惊吓事件”均无临床意义。在剖宫产分娩期间单独使用视觉警报不太可能是令人满意的噪音缓解策略。
目的：我们的目的是对剖宫产期间发生的噪音进行全面分析。
方法：在2021年2月15日至2021年8月26日期间，我们完成了一项关于剖宫产分娩期间噪声水平的干预前/干预后观察性研究，该研究在引入视觉报警系统以减轻噪声之前和之后。
结果：所有剖宫产分娩的声压中位数为61.8[58.8,65.9]dBA（中位数[I.Q.R.]）。
结论：剖宫产期间记录的噪音强度通常在影响沟通和注意力的水平，
