Endocrine Abstracts

Introduction: Noise in the operating room is an ongoing problem and impacts the outcome of surgery. Noise as stressor can produce a startle reaction and activate fight or flight response of the autonomic and endocrine system. The psychobiology of the stress as assessed by salivary cortisol level is a sensitive measure of allostatic load. In this study, we correlated salivary cortisol levels of the surgical team with noise measurement and also whether the noise in OR subjectively affected the operating team.

Materials & amp; Methods: Prospective observational study conducted in OR of a tertiary referral centre. We recorded the noise or from shifting in to shifting out using digital sound level meter. The operating team – Operating Surgeon (S), Anaesthetist (A), Scrub Nurse (N) and Floor Nurse (F) all gave a salivary sample for measurement of cortisol at the end of the procedure. We had measured baseline salivary cortisol for Surgeons. Questionnaire for assessment of distraction was filled in by the S, A and N at the end of the procedure. Salivary cortisol levels were analysed using SLV-4635(formerly SLV-2930) DRG Instruments GmbH German using ELISA. Statistical analysis was performed using SPSS 22.0.

Results: Total of 37 procedures with 148 Salivary Cortisol samples and 111 responses from S, A and N were analysed. All Patients with benign FNAC were operated (64.9% - Colloid). Mean TSH levels were 3.5 ± 6.7. Majority had STN (25/37 67.6%). 18 patients (48.6%) underwent open Hemithyroidectomy 10 patients TT and & amp; 8 patients Endoscopic HT and 1 Pt had sistrunk’s procedure. The Mean Cortisol levels of S, N, A and F and mean noise levels are provided in the table1. There was significant Correlation between mean noise levels and S& #39;s levels. (P<0.05).

Conclusion: Noise levels were high in the OR during initial phase and closure phase of thyroidectomy. ‘S’’ was more affected by noise especially during critical phases of Surgery such as RLN dissection. Serum cortisol level were high for S when compared to N, A and F. No studies in Literature regarding noise correlation and Surgeons stress. Noise is distracting and the effect of long term effect on the surgical team needs to be studied.